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The 2012 Sigma Conference
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4/6/2011
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Service commissioning faces five key challenges, says DoH chief
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Dr James Kingsland
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Commissioning arrangements face five key challenges before they can prove to be workable in a restructured NHS, Dr James Kingsland told the Numark conference in Delhi.
The national clinical commissioning lead at the Department of Health, and guest speaker at the conference, identified important areas that need to be addressed, including patient involvement in commissioning.
That was particularly pertinent given that a select health committee has since warned that GPs should not be the sole commissioners in a revamped NHS and that patients should have a greater say on doctors' budgets.
“(We need) a patient voice in every single general practice and the aggregation of that patient voice and general practice that form consortia will be a requirement to demonstrate that this is a patient-centric NHS,” Dr Kingsland said. “In a macro sense, (it is about) how to make sure that every general practice has got some representative body that is more for their resident population.”
He said that the second challenge was to integrate the collective primary care experience in Needs Assessments. “There is a massive amount of information about patients' needs in other primary care contractors,” Dr Kingsland said. “The challenge is getting that information into the commissioning programmes, that gets clinicians to do the Needs Assessments.” He insisted that pharmacists must open dialogues with GPs on consortia boards and listen to what patients are saying during consultations to “recognise what is not being met by the health service.” He added: “It's about getting a collective view from community pharmacy in a particular geographic area covered by a GP consortia and use that expertise in Needs Assessments.” The third hurdle, he said, was to align commissioning decisions between the health service and local authority and the fourth challenge was to move primary care and long-term condition management into the community, thus freeing up hospital services for “high complex technical interventions.”
Dr Kingsland said the fifth challenge was to get more out of GPs themselves, ensuring they “stepped up to the plate” and collaborated with other primary care contractors. But he added: “We need a multi-approach if we are to move lots of care out of hospitals. That can't be just from GPs and practice nurses or community nursing. It's going to involve an integration between other primary care contractors.”
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