1. Sensitising Commissioners to Local Enhanced Services Judy Oliver Oliver and Company (UK) Limited www.judyoliverandco.com

2. What are we trying to achieve? © Adapted from the work of William Bridges and his book Managing Transitions, Making the Most of Change THE FUTURE (“The Promised Land”) No decision about me without me Right services at the right time in the right place More services closer to people’s homes Better Value For Money/Quality THE NEUTRAL ZONE (“Wilderness”) The In-between phase How do we get to the Promised Land?. NOW (“Egypt”) Too many people are in hospital Costs of secondary care rising fast Hospitals dominate politically

3. What do you think Commissioning means in practice?

4. The Commissioning Cycle Identify needs Monitor DeliveryDefine outcomes Agree ContractProduce specification Find Providers

5. Liberating the NHS 1.Building on the past – Markets, NHS Constitution, Foundation Trusts 2.Invitation to adult relationships based on trust – Clinical Leadership, Simpler Outcomes- focused Monitoring, Partnership 3.Major challenges – Speed of devolution to GP Consortia, Financial Management, Power to the People (Public & Employees)

6. The Health Economy- An Overview LOCAL GOVERNMENTMONITORING AGENCIESNHS Government Departments Regional Govt Office e.g. GOEE/EEDA County Council e.g. Norfolk District Council e.g. North Norfolk IdEA Care Quality Commission Monitor Audit Commission (Plus Many Others) Sustainable Communities Strategy (10-15 year Vision for Quality of Life) Overview and Scrutiny Committee Strategic(Commissioning) Plan (PCT’s Vision for improving health of population) Community Strategy Department of Health Strategic Health Authority.e.g NHS East of England 80% NHS Funds Primary Care Trust e.g. NHS Norfolk Practice Based Commissioning Groups Independent contractors Community Services (Provider Arm) Acute Trusts Mental Health Other Providers

7. LOCAL GOVERNMENTMONITORING AGENCIESNHS Government Departments……………..DH County Council e.g. Norfolk (PCT Public Health Staff to transfer over) District Council e.g. North Norfolk Care Quality Commission (incorporating Health Watch) Monitor (Far fewer additional bodies!) Sustainable Communities Strategy (10-15 year Vision for Quality of Life) Health and well-being Board Community Strategy National Commissioning Board Regional Satellites(?) 80% NHS Funds GP Consortia With Management Support Independent contractors Acute Trusts Mental Health Community Services Other Providers The Health Economy- The Future???

8. What questions do you need to answer? Do you know who your commissioners are and what their priorities are? Do you know the local population’s needs for your service? Do you understand local priorities? Do you know who the competition are? Have you got evidence of patient satisfaction, value for money and quality? What savings can you help to make?

9. What are you trying to achieve? © Adapted from the work of William Bridges and his book Managing Transitions, Making the Most of Change THE FUTURE (“The Promised Land”) If you knew your service is going to work really well, what will the benefits be for patients? THE NEUTRAL ZONE (“Wilderness”) What new things do you need to introduce? NOW (“Egypt”) What do you do well now which you can build on? What do you need to stop doing?

10. Thank You for your Attention www.judyoliverandco.com