1. The New Landscape - Transforming Commissioning

2. Agenda The likely impact of the White Paper on the commissioning landscape The NHS London Commissioning Development programme

3. You may have seen... NHS 'reorganisation' is outlined NHS shake-up 'hands funding powers to GPs radical programme for a radical government NHS revamp to push up standards Biggest reorganisation in the NHS since 1974

4. Andrew Lansley has a clear vision... Andrew Lansley: 'A shared ambition to improve outcomes' patients must be at the heart of everything we do the NHS must be focused on achieving continuously improving outcomes for patients we must empower clinicians we must prioritise prevention and create a public health service we must reform social care alongside healthcare

5. This includes some concrete changes Out with the old, in with the new Funding from DH > SHAs > PCTs > GPs and Commissioned Providers Public Health responsibilities held by PCTs FT status for NHS Hospital Trusts optional Occasional financial bailouts Limited independent sector commissioning support of NHS funded services 80% of funding to be held by GPs, who will commission using an Any Willing Provider model Responsibility for Public Health to be held by Local Authorities All hospital trusts must become an FT, or part of one No bailouts for commissioners and providers Commissioning support will become a new market place for the NHS, with considerable outsourcing

6. The end state will look very different Funding Accountability Parliament DH NHS Commissioning Board GP Commissioning Consortia Monitor (economic regulator) CQC Providers Patients and Public Local Authorities Local HealthWatch Local strategic partnership licensing contract Accountability for results

7. The NHS Commissioning Board will provide national leadership Responsible for: establishing consortia (assigning them if necessary) calculating practice-level budgets (based on weighted capitation) and allocating to consortia ensuring the NHS in England is resilient and is mobilised in times of national emergency It will promote: primary care & family health services – dental, optometry and pharmacy national and regional specialised services maternity care health services for those in prison or custody It will commission: equality in health outcomes choice & personalisation, including personal health budgets research and use of evidence productivity & competition It will promote:

8. GP Consortia will commission the majority of services for their local populations Will need to: commissioning the majority of healthcare services managing combined practices commissioning budgets deciding commissioning priorities to reflect local needs, supported by an outcomes framework Responsible for: commission services using the Any Willing Provider model use a lead commissioner arrangement procure support for commissioning activities Will be empowered to: agree local priorities each year – carrying out patient and public involvement exercises take part in risk-pooling arrangements & appoint staff for statutory governance role ensure continuity of services and promote health equality Will need to:

9. strengthen patient and public voice advise the NHS Commissioning Board, Monitor and the Secretary of State HealthWatch local health improvement local coordination of joint commissioning fund and hold to account local HealthWatch Local Authorities Nothing about me, without me Plus many players in the current structure will be given increased powers to support the new world

10. license providers, alongside Monitor, against safety & quality standards targeted and risk-based inspections, enforcement if standards not met Care Quality Commission economic regulator for providers to the NHS and social care promote and enforce competition & choice powers to set efficient or maximum prices Monitor Greater autonomy will be matched by increased accountability Plus many players in the current structure will be given increased powers to support the new world

11. independent, non-departmental public body develop quality standards for key care pathways social care as well as health National Institute for Health and Clinical Excellence will take over functions of existing improvement & protection bodies set LAs national objectives for improving population health outcomes research and evaluation Public Health Service Improvement in quality and healthcare outcomes is the new governing principle Plus many players in the current structure will be given increased powers to support the new world

12. The scope of NHS Londons contribution to supporting the transition to GP-led commissioning is currently being defined Support development of GP consortiaSupport development of commissioning support marketEstablish NHS Commissioning BoardRealign clinical networksDefine and implement transition structuresJoint working and communications

13. Thank You Rachel Bartlett Assistant Director, Commissioning Development E: rachel.bartlett@london.nhs.ukrachel.bartlett@london.nhs.uk