Market Development and Commissioning

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Market Development and Commissioning

• Peter Boileau

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Themes

• Achieving transformational change
• Promoting health and wellbeing
• The challenge for new commissioning
• Third Sector at the centre of the commissioning
  agenda
• Opportunities
• Barriers
• Third sector and Commissioners developing together

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Commissioning at the heart of system reform
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Commissioning taking the lead

• Public sector role increasingly seen as
  commissioning
• Reform not about provider structures
• Commissioning to drive diversity of provision to
  offer more choice and to deliver better outcomes
• Range of public, private and voluntary providers

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Commissioning and transformational change

• Commissioning to drive real transformational
  change
• Drive new models of service
• Care closer to home
• Commissioning managing pathways of care
  differently
• right care in the right place a the right time
  by the right provider
• Well-being and health improvement as well as care
  and treatment

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High Expectations!

• Public service reform and transformation
• Focus on individual needs, wants and preferences
• Plurality of provision to ensure responsiveness
• Stronger focus on promoting health and well-being
• Measuring delivery through outcomes / user /
  patient experience
• . for the NHS strong perception that
  commissioning was not being done well
• . But that those things which make up
  commissioning are critically important

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Last chance saloon for commissioning!

• Organisational change
• Fitness for Purpose
• Publication of consultation documents on
  commissioning
• Framework for External Support
• Internal and external scrutiny of what
  commissioning is about and how to do it well

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The Commissioning Framework for Health and
Well-being
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Aims
1. A shift towards services that are personal,
sensitive to the needs of the individual and
focused on maintaining independence.

• A reorientation towards promoting health and
  well-being, and proactive prevention of ill
  health.

3. A stronger focus on commissioning for
outcomes, across health and local government,
working together to reduce health inequalities
promote equality
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Market Shaping/Development

• Wider range of more innovative providers
• Look outside of traditional care and treatment
  providers
• Care closer to home, prevention and early
  intervention
• Commissioners must shape the market to stimulate
  and sustain new providers
• Need to address the barriers to entry

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Market Shaping/Development

• Health commissioners have been very wary of using
  community and voluntary groups to deliver
  services
• Third sector providers may find it difficult to
  enter new areas without active support because
  the barriers to entry are too high

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Why is it like this?

• How will it change?

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Commissioning Now?

• list of services
• Activity
• Volume/money
• Draw up contract
• Negotiate contract
• Activity/price/cip
• replace contract with same providers
• Monitor activity
• Status quo/marg change

• ? No vision
• ?no commissioning strategy
• ? No real need assessment
• No market shaping
• ?No outcomes defined or measured

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New Commissioning

• Commissioning vision/strategy
• Strategic need assessment
• Engage community in stating needs and wants
• Community identifies service gaps
• Need identified for new providers
• MARKET DEVELOPMENT
• Provider capacity building

• Service outcome/specifications
• Contracts drawn up
• Contracts negotiated
• Outcomes and quality agreed
• Contact monitored
• Outcomes measured and delivered
• Strategy revisited and revised

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Third Sector and Commissioners Joint Development

• Commissioners dont understand third
  sector-structure, issues and potential
• Third sector dont understand commissioners or
  commissioning
• Structured awareness training in localities
• Identify where business agendas overlap and where
  the incentives to collaborate are
• Agree an ongoing dialogue/action plan

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Building Capacity of CVS/Third Sector

• CSIP pilot work with three rural organisations
• Capacity building
• Being fit for purpose
• Disseminate learning and experience

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Barriers and Challenges

• Bureaucracy and heavy monitoring
• Full cost recovery issues
• Smallness and infrastructure
• Partnership and structure of CVS
• Fit for purpose
• Building capacity
• Model contacts
• Compacts

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What the Third Sector Bring to the Agenda

• Real community engagement vital for need
  assessment
• A legitimacy for the local commissioning function
• Value for money by altering balance of care
  (early intervention, prevention and well-being
  services)
• Real user choice
• Better and more holistic outcomes