1. Co-commissioning of Primary Care
What is it?
The options/models available to us
What difference will it make?
The further development of strong local relationships with the voluntary sector

2. What is Co-commissioning?
CCGs are being asked by NHS England to join commissioning up by taking on more areas of responsibility
Currently commissioning arrangement are split:
CCGs have responsibility for secondary care (hospital care)
NHS England has responsibility for primary care (GP practices, dentists, community pharmacies and opticians)

3. The Intention was to avoid conflicts of interest in commissioning arrangements
In practice this has led to fragmentation and has made it hard to commission whole system integrated pathways of care

4. So……
CCGs now have an opportunity to take on additional responsibility for commissioning primary care
Initial offer is specific to general practice
Aim to have more joined up approach between the CCG and NHS England to best meet the needs of the local population
Co-commissioning doesn’t include duties relating individual performance management of GPs (retained by NHS England)

5. ‘place based commissioning’
And this should…..
Help us to improve and create opportunities to transform primary care services locally
NHS England have a new term –
‘place based commissioning’
and Co-commissioning should help us to move towards this approach so that we have the best possible services in South Tyneside
A more affordable, integrated high quality healthcare system, better able to meet the local needs
Improved delivery of integrated out-of-hospital services
More informed local decisions re deployment of resources to primary care
Consistency between outcome measures/incentives in primary care and wider out-of-hospital services
Greater opportunities to influence whole systems change
Next steps for Primary Care co-commissioning published 10th November 2014
Proposal to transfer certain commissioning responsibilities from NHS England to CCGs

6. The Options Available
We had various ‘levels’ of responsibility and autonomy to choose from
Aim to have more joined up approach between the CCG and NHS England to best meet the needs of the local population

7. Delegated Arrangements
The 3 Options were
Model 1
Greater Involvement
Model 2
Joint Commissioning
Model 3
Delegated Arrangements
greater collaboration with Area Team
greater involvement in primary care decision making
working closely with Area Teams to influence and shape primary care
CCGs assume joint commissioning responsibilities with Area Team via creation of ‘Joint Committees’
CCGs would be required to amend their constitutions to reflect this
CCGs assume full responsibility for commissioning primary care services
GMS/PMS Contracts
Enhanced Services
Property Costs
QOF or alternative local scheme

8. Option 2: Joint Commissioning Arrangements
Our View
The Council of Practices has considered the 3 options and chosen
Option 2: Joint Commissioning Arrangements
If and when we feel ready in the future we can then move to full delegated responsibility
Start Date: 1st April 2015

9. What difference can co-commissioning make?
Strategically and operationally able to influence developments such as:
Practices changes such as mergers or relocation
Shaping consultations with the public to seek their views on service design and location
Design new development schemes
Flex local approach and best meet local needs

10. Potential pitfalls
Likelihood of implementing national direction, e.g. Contract reviews
CCG overall capacity
Need to manage the conflicts of interest of GPs being involved in commissioning their own services
Potential to change relationship with member practices
But on balance option 2 is the best way forward for ST

11. Strong and local relationships with our voluntary sector
We will be establishing a new committee
The South Tyneside Joint Primary Care Committee
Healthwatch and the Health and Wellbeing Board will be invited to become members to influence the business and ensure that the patient, carer and wider stakeholder voice is heard
Co-commissioning is reliant upon the development of strong local relationships and effective approaches to collaborative working

12. Q&A