1. Towards Clinical Commissioning: Translation of Impact Assessment Dr Phil Webb, WHSSC

6. Bridge from Evidence to Impact Assessment and Commissioning Methods

7. Impact Assessment CLINICAL ENGAGEMENT QUALITY, OUTCOMES, HEALTH IMPROVEMENT PATIENT AND PUBLIC FINANCIAL: COST CONSEQUENCES

8. Clinical Engagement All Programmes Teams (not Mental Health) Renal Network (2 meetings) Cardiac Network and Welsh Cardiovascular Society (4 cardiac meetings, 2 CF) PET (2nd meeting) HSCT (1 meeting) ERT (1 meeting) English Specialised Services Portfolio Board NHS Wales Medical Directors CMO and Deputy CMO

9. Commissioning Actions Development of: Clinical Access Policies; Service Specifications and Quality and Outcomes dashboards

10. Integrated Healthcare Commissioning? Pathway(s) for stable angina Disease Severity and Clinical Risk Diagnosis Intervention 1000s100s10s WHSSC HEALTH BOARD NCE CG126 Diagnostics and testingOptimal Medical Therapy Assessment Refractory Angina ? MIND THE GAP Written Evidence Based Protocols? Audit?

11. Empirical Data To Support Pathway Reconfiguration?

12. Clinical Reference Groups Set up to develop Clinical Access Policies Review Services Specifications Describe and identify clinical parameters for Quality Dashboards New way of working (evidence based, explicit, audited, outcome focused)

13. Questions How do we ensure that the agreed policy is implemented? – Pathways; – Contracts; – Clinical Gatekeepers; – Communications (patients and the public)

14. Thanks for the Engagement (but here’s to getting out of the Basement) There is a theory which states that if ever anyone discovers exactly what the Universe is for and why it is here, it will instantly disappear and be replaced by something even more bizarre and inexplicable. There is another theory which states that this has already happened. Many were increasingly of the opinion that they’d all made a big mistake in coming down from the trees in the first place. And some said that even the trees had been a bad move, and that no one should ever have left the oceans. “My doctor says that I have a malformed public-duty gland and a natural deficiency in moral fibre,” Ford muttered to himself, “and that I am therefore excused from saving Universes.” Not unnaturally, many elevators imbued with intelligence and precognition became terribly frustrated with the mindless business of going up and down, up and down, experimented briefly with the notion of going sideways, as a sort of existential protest, demanded participation in the decision-making process and finally took to squatting in basements sulking.