Choice Need Want StrategyWorkforce ? OutcomesParticipation Budget Existing Quality & providers value Alternative providers
Population needs assessment Usually produced by Public Health Need department (based in local Want NEED authority). WANT Choice CHOICE Should include:Estimated need - prevalence dataService map with gap analysisEvidence of best practice AnalysisAnalysis of what people want
Commissioning strategy Usually produced by the Strategy commissioning team (could be Outcomes NEED WANT Budget joint between CCG and LA). CHOICE It is the plan of:What outcomes need to be deliveredBy what sorts of servicesWithin a specified budget Planning
Allocating resources Commissioners may continue to Quality fund existing providers, with a Value NEED service specification. WANT Providers CHOICEThey may also commission new or alternativeproviders by:Tendering SourcingProcurement
Checking quality and value Contracts reviewed by activity Workforce and outcome reports from the NEED Participation WANT provider workforce. CHOICE Outcomes and quality (experience of service) are sought by:Public and patient involvement (PPI)Service user participation Monitoring and review
The commissioner’s role...is to bring resources and strategic direction tothe commissioning process, designing andimplementing the range of services required,rather than only purchasing from servicescurrently available.
Who will the commissioners be• Clinical commissioning groups (GPs and other primary care professionals)• Local Authority commissioners• With support from those with more commissioning experience (for example ex- PCT commissioners)
Joint commissioning...is the process whereby partners who haveresponsibility for specifying, securing andmonitoring services work together to makejoint decisions about the needs of theirpopulation, and how they should be met.
Effective commissioning...has the potential to help in the improvement ofservices because it places the primary focus onthe needs and aspirations of patients and theirfamilies, unclouded by other considerations.
How is that achieved?By finding out:• What people need (population needs assessment)• What people want (public and patient involvement, advocacy)• Then acting upon it
A key aspect...of the commissioning agenda is to focus on earlyintervention and prevention wherever possible,rather than waiting for a crisis presentationneeding acute or restorative services.
How does that relate to epilepsy?• Public information and challenging stigma• Educating that there is a role for early intervention and preventative work in epilepsy.• Pre-conception and maternity services• Accurate diagnosis• NICE CG 20 standards