My mission statement

The times we are working in now need a great deal of accelerated change and there must be no negotiating that down. So my mission statement for this part of my consultancy career is to be clear that there needs to be and will be a lot of change from the work that I do with individuals and organisations and if organisations don’t want that, then it is probably best to go somewhere else.

Read my statement in full »

How CCGs can stick to their mandate and develop patient-led value for the NHS.

Filed Under (Clinical Commissioning Groups, GP Commissioning, Health Improvement, National Commissioning Board, Patient involvement, Self Management) by Paul on 21-11-2012

This evening, at about 18.15, I am speaking to the NHS Alliance conference in Bournemouth. My theme tonight, as it has been for some time now, is how the NHS can develop better public value by viewing people with long-term conditions as ‘assets’ rather than as ‘costs’.

I spoke about this at the NAPC in October and will do so again at the Alliance. What is important for today’s audience is to underline practically how GP commissioners need to commission interventions that increase a patient’s capacity to self-manage. Just as other sorts of healthcare cost money, so does this form of provision. Although it’s a lot cheaper than a stay in a hospital emergency bed (in fact almost everything is a lot cheaper than an emergency bed stay in a hospital) it still needs to be commissioned rather than expecting it to happen for free.

What will be different about today’s talk is that it follows the publication of the Secretary of State’s mandate for the National Commissioning Board. The mandate has a specific objective about the co-production of health care which will be passed onto the CCGs. It reads like this:-

“ 2.1 We want to empower and support the increasing number of people living with long term conditions. One in three people are living with at least one chronic disease. By 2018 nearly 3 million people, mainly older people, will have three or more conditions all at once

2.5 The NHS commissioning board’s objective is to ensure the NHS becomes dramatically better at involving patients and their carers and empowering them to manage and make decisions about their own healthcare and treatment. For all the hours that most people spend with a doctor or nurse, they spend thousands more looking after themselves or a loved one.

  • Far more people will have developed the knowledge skills and confidence to manage their own health so they can live their lives to the full
  • Everyone with long term conditions, including people with mental health problems will be offered a personal care plan that reflects their preferences and agreed decisions
  • Patients who could benefit will have the option to hold their personal health budget, subject to the evaluation of the pilot programme as a way to have even more control over their care;
  • The five million carers looking after friends and family members will routinely have access to information and advice about the support available- including respite care 

The NCB therefore has – as an objective – that the NHS becomes dramatically better at empowerment.

Now it might be that all this stuff, mandate and all, means nothing and the NHS sails serenely on as if nothing has happened. The reforms and all its intentions will wash up against the NHS as it is and has always been – and nothing changes.

Or it could be that the NCB really tries to reach this objective and looks to CCGs across the country to commission pathways of care that will make a real difference to patients by being able to better self manage their condition.

The mandate even mentions the most important fact that patients with long-term conditions and their carers spend thousands of hours looking after themselves but only have a few hours being looked after by the NHS.

You can read my talk here.


One Response to “How CCGs can stick to their mandate and develop patient-led value for the NHS.”

  1. You rightly say that CCGs should ‘commission pathways of care’ so that those with chronic conditions can manage them successfully.
    But isn’t the problem that this is a function of primary care and CCGs only commission secondary care. Primary care, including dentistry in which I worked for many years, is commissioned by NCB.
    Perhaps what we need are local organisations that commission primary care locally. Perhaps they could be called Primary Care Trusts!!

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