1. Step 1: What population should you focus on?
 Understand population priorities – CCG and
locality level
• What do members think needs improving?
• What populations are not getting high
value?
• Where do local providers feel change is
needed?
Review two and five year plans to align priorities
Health and wellbeing strategy and JSNA
What does the data say- Right Care information
Ensure CCG understands potential barriers
Step 2: Define the population – build case for
change
 What are the parameters of the patient population,
where does it start/end?
Who are the providers/clinicians currently involved
Establish governing body commitment for change
and willingness tackle barriers to change
Build a case for change
o Review of existing contracts, identification of
risk
o High level financial review
o Identify key areas of potential resistance to
change
o Engagement programme
Step 3: Raise awareness and begin
engagement with system (patients, carers,
clinicians, providers, other
commissioners)
 Awareness of approach and requirements
for change across present and potential
system
Proactive expressions of interest to ensure
full provider landscape engagement
Personal contact with key system leaders,
ensuring clarity on purpose, requirement for
change and potential risk/benefits
Promote, enable and facilitate provider
discussion to begin thinking/acting as a
system
Engagement plan with patients, public
carers. Utilising local groups, proactive
session and social media.
Facilitate system wide discussions to test
approach
Step 4: Determining the financial
envelope
 Identify historic spend for population
across system
Benchmark spend against other like areas
Define financial and contractual
parameters to reflect scope of service
Make a value based commissioning
decision – what should we spend?
Step 5: Determine the right outcomes
for population
 Work with patients, clinicians and
provider to determine high level
outcomes of service; what benefits&
standards should patients expect the
health care.
 Determine indicators and measures to
demonstration achievement of
outcomes
Set thresholds for indicators
Step 6: Sense check with system
 Understand the level of
achievement that may be expected
given the resources available
 Informal negotiation with systems
of providers
Value based
commissioning road
map- initial
development and
engagement
Step 7:
Determine the
right
procurement
process