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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
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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)
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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
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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)
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‘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
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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
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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
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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
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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
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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
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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
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Q&A
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