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Delivering a fair. personalised, effective and safe NHS

By placing greater emphasis on assessing local needs, and prioritising investments to deliver long-term improvements in health outcomes, world class commissioning will be pivotal in reducing health inequalities.  Furthermore, world class commissioning will support the shift from treatment and diagnosis to prevention and the promotion of well-being.  This is crucial for delivering a fair health service as lifestyle choices are responsible for as much as half of the gap in health outcomes.

World Class commissioning encourages patient engagement and greater clinical involvement throughout the commissioning process.  Increased clinical and patient input, combined with a more accurate assessment of long-term local requirements, will ensure services are more closely designed to meet evolving patient needs.  By encouraging new services and providers, and promoting greater choice, world class commissioning will open up new opportunities for innovative local care solutions – again centred around the needs of the patient.  In doing so, they will create an environment where innovation thrives and where safety and quality become pre-requisites.

By further strengthening relationships between key local partners such as PCTs and local authorities, world class commissioning will ensure better links between different aspects of patient care – again, ensuring overall care solutions are highly personalised and effective.

An innovative approach to service design

There are already several examples of where an innovative approach to commissioning is supporting the vision of an NHS which is fair, personalised, effective and safe, and delivering the outcomes aspired to in the next stage review from staying healthy to end of life care. 

For example, Heywood, Middleton and Rochdale PCT have joined forces with Sport England and the Big Lottery Fund to regenerate sports facilities in the community, supporting the long-term shift from diagnosis and treatment to prevention and the promotion of well-being. The PCT has also employed dedicated community workers to develop services that are of interest to the local population to encourage healthy lifestyles and improve public health. 

Bournemouth and Poole PCT have, in partnership with their practice based commissioners, set up a new community based palliative care service that is improving end of life care for patients. 

In Liverpool, the local PCT has set a up a social inclusion team, who between them speak 13 different languages.  The team will identify important health trends within different parts of the community and will help to widen healthcare access for people from ethnic minority groups.

In Birmingham, three PCTs have joined forces to improve male life expectancy, combatting cardio-vascular disease (CVD) in new and innovative ways.  Having identified the patients most at risk of CVD, they commissioned a pilot pharmacy screening service for the disease.  The practical location of many of the participating pharmacies, along with their extended opening hours and ‘drop in’ approach, increased access for patients across Birmingham and in particular targeted deprived communities and those with lowest male life expectancy.

Next steps

These are just a few examples of excellent commissioning. The next step, and aim of the world class commissioning programme is to ensure commissioners systematically develop a world class approach in everything they do. By doing so they will deliver long-term improvements in the health and well-being of their local communities and support the NHS vision set out in the next stage review.