1. Policy and Practice The changing face of commissioning in primary care Dr Anne Mackie

2. Why countenance change ? PCTs originally set up to commission on behalf of their populations and to take cognizance of the commissioning intentions of primary care Systems worked in some areas better than others – but expected improvements did not materialize fast enough Our populations deserve better – hence initiatives like practice based commissioning are some of the initiatives which will drive change

3. Is primary care up to the task ? Where are the commissioning skills ? Where is the knowledge outside their areas of experience ? Is primary care homogenous enough to be able to take on this task ? Is primary care able to understand and access the evidence base on which to base their initial commissioning assumptions

4. How can I contribute to the cycle of effective commissioning? Assessing need Reviewing provision Deciding priorities Designing services Shaping the structure of supply/procurement Contracting Clinical decision making Contract management Seeking views of patients and the public

6. What can I do today? Get to know your area Exploit your skills and share your knowledge Develop relationships with primary care Assist with the evidence base Help with the interpretation of data – as far as you can Encourage and support – you are a potential user too – it is in your interest

7. What will the landscape look like ? Primary care will be made to be more consistent in terms of accountability, quality and depth Public health will be seen as an integral and essential part of the commissioning process – straddling primary care and the PCTs – with responsibilities in both areas Knowledge will be available and accessed regularly– not just masses of data only comprehensible to the few