1. Developing a vision for PBC / clinical commissioning in NHS East Midlands
Jeff Anderson
11th March 2010

2. Overview
To develop a vision for PBC / clinical commissioning and a strategy for implementation in the light of current and future challenges which face the NHS
Vision
SHA feedback from PBC lead
Capture initial views on the challenges for the future of clinical commissioning
Describe what clinical commissioning will look like in the future around key themes for success
Objectives
22nd February 2010
Stakeholder session
GPs, PBC leads, PCT senior manager representatives (16)
Involvement
04 May 2019

3. Summary of Challenges
Different levels of GP understanding on hard budgets, and what it means for them
Link between primary care performance and clinical commissioning
GPs will take notice
Different models may emerge – locality based; non-locality based
Challenges for PCT, PBCs and GP levels
Cultural and structural clashes
Misalignment of current incentives
Capacity, skills and confidence to lead the changes, transfer and manage hard budgets
GP freedoms to innovate and take more control to create balance in the system
Requirement for intelligent commissioning – transparency of contracts, data, and performance management
Short sightedness – immediate pressure v long term change
Addressing significant primary care variation
04 May 2019

4. Emerging Themes (and possible actions)
Managing people and systems difficult – ACCEPT AND SUPPORT THIS
Governance systems and processes – AGREE THIS
Incentives and rewards – REALIGN THIS
Enabling clinicians to lead – ENABLE THIS
PCTs to be PBC-facing and to ‘let go’ – ACCEPT THIS
Control and influence gained by clinical commissioners – LEAD THIS
Primary care and clinical commissioning – The bottom line! – GET A VIEW ON THIS
Readiness for hard budgets – CHECK THIS
Pilot real budgets – DO THIS
New models to emerge if hard budgets a reality – SCOPE THIS
04 May 2019

5. Success statements…
A successful clinical commissioning culture is … where you listen to and involve clinicians, the work is driven by clinical and patient issues, and at the same time taking responsibility to enable commissioning change through partnership working and [letting go] risk taking from top to the bottom of the local health system
Clinical commissioning roles for success come from … defining, accepting and believing in the role of a clinical commissioner at practice, PBC and PCT level, recognising the responsibilities of each and overcoming barriers to entry as well as increasing earned autonomy in the system
04 May 2019

6. Your views count! - Questions
What will be necessary components in implementing successful clinical commissioning across the East Midlands?
How should these be addressed?
04 May 2019