1. Workshop A -Commissioning Finance Danny Storr – Head of Finance NHS Hull Clinical Commissioning Group

2. j
CONTENT
So what is Commissioning
Accountabilities and Responsibilities
Financial Duties for Commissioners
The main challenges for commissioning
What does the future hold

3. So what is commissioning?j
“It is the process by which commissioners identify the health needs of their population and make prioritised decisions to secure care to meet the needs within available resources.”

4. So what is commissioning?j

5. How the PCT spends its money:
So what is commissioning? j
How the PCT spends its money:
Area of Spend %
Acute Contracts (inc specialised)
44%
Primary Care, Dental, Pharmacy, Ophthalmic
16%
Non-NHS Healthcare Contracts (inc reablement)
13%
Primary Care Prescribing
10%
Mental Health & Learning Disabilities Contracts 7%
Continuing Healthcare 4%
Ambulance Contracts 2%
PCT Running Costs
Other
Total
100%

6. Accountabilities and Responsibilities
cfS
The Old Structure

7. Accountabilities and Responsibilities
The New Structure

8. Responsible for spending tax payers money
Accountabilities and Responsibilities j
Responsible for spending tax payers money
Responsible for achieving value for money i.e getting the most out of every £ spent
Standing Financial Instructions govern the rules

9. Financial duties for Commissioners j
Remain within revenue and capital resource limits
Not to spend more cash than we are allocated i.e. not to be overdrawn at the bank
To pay 95% of invoices with 30 days
To remain within running cost (previously management cost) targets
Submit statutory returns (annual accounts & audit)

10. Major financial challenges in Commissioning Exercise

11. j Some of the challenges:
How the funding will be divided across the new system
Hitting financial targets (either way)
Prioritising which areas of health to spend resources
Dealing with conflicting demands (long term v short term)
Market Management / behavioural changes
Clinical Engagement (all above)
Delivering QIPP agenda
Coping with change

12. j Dealing with the challenges:
Strategic direction set by the Board (using Public Health Science)
Well structured planning process (start early)
Engaging stakeholders in development of services
Effective budgetary control procedures (plan A,B, C…)
Good relationships with providers
Good lines of communication throughout the organisation and with the public
Strong understanding of cost drivers and knowledge of contracts
Teamwork

13. What does the future hold? j
PCTs and SHAs will be abolished
NHS Commissioning Board created
Clinical Commissioning Groups created
Commissioning Support Services created
Local Authorities / Public Health England altered / created
Property Services Ltd created

14. What does the future hold? j
Commissioning of services from April 13 will be as follows:
Public Health commissioned by local authorities NHS CB and PHE
Primary Care commissioned by NHS CB
Specialist Services will be commissioned by NHS CB
Everything else will be commissioned by CCGs
Estates managed by Property Services Ltd

15. j
Questions???

16. Stage 1 – Strategic Planning
So what is commissioning
Stage 1 – Strategic Planning
Identify need
Review pathway and current services
Decide priority requirements (evidence based)
Products and tools for this stage:
Joint Strategic Needs Assessment
Commissioning Strategy
Medium Term Financial Plan (which is purely a financial interpretation of the commissioning strategy)

17. Stage 2 – Commissioning & Procure Services
So what is commissioning
Stage 2 – Commissioning & Procure Services
Design pathway, services and specifications
Plan capacity and manage demand
Market management and procurement
Contract for Service
Products and tools used for this stage:
Service specifications including KPIs and information requirements
Contract documentation and governance framework e.g. Contract management Boards
Budget and activity information available
CQUIN indicators

18. Stage 3 – Performance Management and Evaluation
So what is commissioning
Stage 3 – Performance Management and Evaluation
Manage performance
Evaluate outcome and provision
Products and tools for this stage:
Monthly, quarterly and annual performance reports on financial and other indicators
Provider management framework