1. Why does commissioning matter? Dr Kev Smith FFPH Deputy Director Healthcare, Public Health England Centre, Yorkshire and the Humber

2. Commissioning What is it? Who does it ? Why does it matter?

3. Commissioning What is it?

4. What is commissioning? Commissioning is ensuring the availability of appropriate services required to meet the health needs of the population

5. Commissioning Who does it?

6. Who commissions? Up until April 2013 the NHS had just two sets of commissioners: Primary Care Trusts and Strategic Health Authorities However- SHAs only buy a small list of services through NHS London (NSCAG, NSCT, AGNSS)

7. Who commissions? PCTs were responsible for all healthcare commissioning (except national commissioning) PCTs worked together at regional level to commission specialised services

8. Who commissions? Primary Care Trust Department of Health Strategic Health Authority SCG NSCT Money Regulations Delegation Local Regional National

9. Primary Care Trust Practice Based Commissioning Units SCG NSCT 1 10 153 500+ 50000000 150-850000 30-250000 5-8000000 Who commissions?

10. April 2013

11. How have things changed?

14. Primary Care Trust Department of Health Strategic Health Authority SCG NCG Money Regulations Delegation

15. How have things changed? Primary Care Trust Department of Health Strategic Health Authority SCG NCG Money Regulations Delegation

16. Who commissions? Clinical Commissioning group Department of Health NHS England 96.6 67 Regulations Money 1.8 Sec 7A Top Tier LAs Public Health, School nursing, weighing and measuring Primary care (12), Immunisation and screening, Health visiting (1.8), Specialised services (13.5) Community services, Urgent and emergency care, Secondary care

17. Who commissions? NHS England allocates funding to CCGs to commission secondary and community care services for their population NHS England directly commissions the remaining elements of the NHS

19. Commissioning Why does it matter?

20. 1.165 In contracting providers, commissioners – not the provider – should decide what needs to be provided, but they should consider the views of clinicians, including those from providers and elsewhere, on commissioning needs as they consider it appropriate. Commissioners should also consult others, as they deem necessary, including GPs and procurement expertise, to improve their commissioning arrangements. Commissioners should also consult and liaise with other commissioning bodies, as they deem necessary, to achieve the necessary expertise or commissioning power to secure effective arrangements. http://www.midstaffspublicinquiry.com/report Commissioners decide what providers provide

21. Why does it matter? Getting funding for an extra clinic PBR Service development Commissioner benefits

22. Why does it matter? Getting additional beds Strategic Clinical Networks Operational Delivery Networks Service development Commissioner benefits

23. Why does it matter? Getting funding for a new procedure Trust new developments group Commissioner agreement Standards for provision Determining centres

24. Conclusion Commissioning is the link between need and provision. Commissioners need advice and support from expert clinicians

25. Commissioning kevin.smith1@nhs.net kevin.smith1@nhs.net @smithkjj