Commissioning in Crisis

Commissioning in England and Wales is failing at every level and squeezing small and medium-sized charities out of service provision, research by the Lloyds Bank Foundation has found.

The report, Commissioning in Crisis, says examples of poor practice in commissioning “far outweighed the good”, and calls for the government to introduce a target for public spending with small and medium-sized charities.

The report collates anonymous evidence from charities with annual incomes of between £25,000 and £1m about their experiences of competing for more than 120 different tenders from local authorities, clinical commissioning groups, police and crime commissioners and central government departments.

Rotherham Community Strategy Update November 2011

Rotherham Together Partnership Board presentation updating on progress of the revised Rotherham Community Strategy and next steps

Building Health Partnerships: Emerging Actions

The Building Health Partnerships programme aims to improve health outcomes through the development and national sharing of best practice in partnerships and relationships
between Clinical Commissioning Groups (CCGs) and the voluntary, community and social enterprise (VCSE) sector.

Supported by the NHS Commissioning Board, the programme is run by the National Association for Voluntary and Community Action (NAVCA) and Social Enterprise UK (SEUK) in
association with the Institute for Voluntary Action Research (IVAR).

This short report, ‘Emerging actions from local areas (part 1)’, presents a snapshot of action planned in six of the 12 Building Health Partnership (BHP) areas: Bristol, Croydon, Durham,
Hackney, Swindon and Wakefield. These six areas have completed both the diagnostic and partnership development sessions of the programme.

The Power of Partnerships: Working with the VCSE Sector for Health

This resource offers practical tools and support to CCGs, HWBs and VCSE organisations to develop effective partnerships to deliver better health care.  Its aim is to help people working in health think differently, more creatively and more practically than ever before, about the opportunities they have to meet changing health needs in difficult economic times.

The New Health Landscape – An Overview for the VCS

Regional Voices has produced a useful presentation providing an overview of changes to health structures

Open Public Services: Experiences from the Voluntary Sector

This report  from NCVO assesses the involvement of voluntary organisations in public services. The report was created in partnership with 14 organisations, including the British Red Cross and Age UK.

Confidence Course and Mentoring

In response to talking to local people, Cheshire West and Chester Council has devised a group-based confidence course – called Five to Strive – complemented by one-to-one mentor support sessions to help participants achieve personal goals.

This report summarises their work so far:

Projected NHS and Public Health Spend under New Commissioning Structure

The Department of Health, in this paper, has brought together two separate collections of 2010-11 Primary Care Trust spend that focused on public health and NHS Commissioning Board or Clinical Commissioning Groups to estimate how those resources would be deployed under the commissioning architecture proposed in the Health and Social Care Bill.

While these should be recognised as estimates at this stage, and further analysis is needed before 2013-14 allocations can be set, they do support initial planning by emerging Clinical Commissioning Groups and Local Authorities.

In this paper, we bring the results of these collections together with information from accounts and other sources to provide the best available estimate of how spend by PCTs during 2010-11, adjusted to a hypothetical break-even position, would map on to the new commissioning architecture. Our analysis is broken down to regional and individual PCT level. When uplifted to 2012-13 levels these offer a first indicative estimate of local baselines, supporting planning and the further development of the commissioning architecture.

The analysis also gives us the first reliable estimate of the current spend in areas that would be the responsibility of the public health system. Adding spend from central budgets to the spend by PCTs in Table 1, and adjusting for spend we believe it has not been possible to separate from CCG spend, we estimate that during 2012-13 the NHS will spend £4.6bn on public health services4. Of this, about £2.2bn will be spent on services that would fall in the future within the responsibilities of local authorities. This paper includes our estimates of how this baseline spend is distributed across local authorities.

The information we have collected has also allowed us to estimate the size of spend on future CCG responsibilities, around £64.7bn, as well as estimates of the spend in some significant areas that NHSCB will directly commission. However, our analysis does not include some areas that are currently funded through Strategic Health Authorities, such as primary care in prisons.

The aggregate breakdown for England is shown in Table 1.  of the paper. The estimated breakdown of 2010-11 spend by PCT and Strategic Health Authority is presented in the accompanying Excel workbook, while the estimated spend on public health in LA  areas (for relevant responsibilities) is shown in the Table at Annex A.  The original data returns for each PCT are being placed on the Department of Health Website.

Impact of community-based interventions on hospital use

In recent years, the Department of Health has encouraged efforts to deliver more care in community settings, with the joint aims of avoiding unplanned admissions to hospital and reducing net costs. Interventions that prevent such admissions can, in theory, both improve the quality of care delivered and help address the financial challenges currently faced by the NHS. This research summary outlines the findings of an evaluation conducted by researchers at the Nuffield Trust that examined whether eight such interventions achieved a reduction in hospital use. The evaluation was conducted using a person-based, risk-adjusted approach.

NHS Equality Delivery System 2011

The Equality Delivery System is designed as a tool to be used to help all staff and NHS organisations understand how equality can drive improvements and strengthen the accountability of services to patients and the public. It will help ensure that everyone – patients, public and staff – have a voice in how organisations are performing and where they should improve.

The EDS is designed to support NHS commissioners and providers to deliver better outcomes for patients and communities and better working environments for staff, which are personal, fair and diverse. The EDS is all about making positive differences to healthy living and working lives.   It is made available to the NHS as an optional tool

NHS Rotherham has adopted the EDS tool and is using it to consider the extent of health inequalities and equality issues in our area.    NHS organisations adopting the EDS need to identify local interests that will need to be involved in implementation, and this includes VCS organisation.  NHS Commissioners may also require providers working to contracts with the NHS to implement the EDS via a term in their contracts.