1. 22 Commissioning healthcare Counselling and Psychotherapy Journal October2012 23Commissioning
W
e are witnessing dramatic
changes to commissioning in
NHS England due to the
revised Health and Social
Care Bill. As many of you will be aware, these
changes have enforced the disbandment of
Primary Care Trusts (PCTs), the formation of
Clinical Commissioning Groups (CCGs) and
a patient-led philosophy which is seeing
some clinicians pushed to the forefront of
NHS commissioning.
Depending on your role, the type of service
you work in and its contractual agreements
with PCTs and/or GP practices, you may be
familiar with current commissioning
protocols. You might also be directly
involved in engaging with local
commissioners and GPs about service
provision. Alternatively, you might be
employed by an NHS-funded service and
have no involvement in commissioning.
Whichever perspective applies to you, this
article will help you understand how current
changes in NHS England might impact on
your service.
Itisclearthatnewcommissioningguidelines
and the implementation of Any Qualified
Provider (AQP) over the coming months and
years, may affect the ‘status quo’. Current
providers will
need to retender
under new
protocols and, in
particular in the
case of AQP,
alongside
practitioners and
service providers
who are new to
contracting with
the NHS.
The AQP model
is part of the
current
Government’s
strategy to
regulate the NHS
market through
fixing the price of
services and licensing service providers.
This provides CCGs with the opportunity to
adopt national guidance (with some set
criteria) and adapt this to create local AQP
requirements and guidance. Then CCGs can
invite service providers to complete tender
documentation to demonstrate they meet the
local AQP requirements. All services that
successfully meet the criteria will be granted
an AQP licence, and when GPs make
referrals they will allow clients to choose
a service from the approved AQP list.
Local implementation of the AQP model
for psychological therapies is not currently
widespread. BACP is aware that
commissioners in Hertfordshire and Bristol
are already implementing AQP in this
commissioning cycle, and in a few other
areas, such as Cornwall and Devon,
commissioners are taking steps towards
AQP for psychological therapies. Taking
this into consideration, are you aware of
how your locality is responding to AQP?
Gaining an understanding of national AQP
guidelines and local implementation plans
will be advantageous to service managers
and counsellors who hold contracts with GP
practices; particularly when considering if
and how to engage with NHS
commissioning. Counsellors and
psychotherapists who are currently
contracted by GP practices may find it useful
to prepare for AQP in their locality by
contacting other therapists working in GP
practices. Now is a good time to consider
collaborating in order to form a service that
would meet the requirements of AQP if and
when it is implemented. This is because
the requirements and criteria currently set
for AQP are geared towards services or
agencies rather than individuals. To find
out more about how AQP is being
implemented for psychological therapies,
visit: www.supply2health.nhs.uk
A reassuring consideration in all this change
is that, in most areas, there is time to get
organised. The CCGs take over full control in
April 2013 and the commissioning process
will most likely begin in October with
contracts usually awarded the following
April. Now is the time for service providers to
collaborate, prepare business plans and start
forging relationships (see below for details
on BACP’s support project).
For now, most commissioners of
psychological therapies remain driven by
the need to meet challenging targets for
Improving Access to Psychological
Therapies (IAPT) services and are
concerned about how they will meet
additional targets and requirements of
extending access to new groups of clients,
such as older people, people with severe and
enduring mental illness and people with
long-term conditions.
Support for BACP members
Regardless of developments in IAPT and the
implementation of AQP, the restructuring of
the NHS alone is going to have a varied
effect on BACP members. BACP is taking a
proactive approach to supporting members
through this transition; we intend to do this
by providing you with:
—Online training to help providers engage
effectively with commissioning.
— A free toolkit of resources to support this
engagement in a practical way.
—Resources to help members engage with
GP practices as advocates of counselling.
— Clinical commissioning forum events in
three or four regions.
—Support for members by phone
or email.
To assist members who wish to make contact
with their local CCG, BACP is also providing
access to an online database supplied by
Binleys. You can access the online map of
current CCG groups by visiting:
http://www.bacphealthcare.org.uk/NHS%
20Commissioning/Latest Information.php
The resources BACP is developing aim to
assist members who are responding to the
commissioning opportunities described in
this article and/or assist members who wish
to understand more about NHS reform so
they can engage in a meaningful way –
effectively representing their service and
profession.
So, if you want to engage in this agenda
locally, where do you start? In September last
year,BACP launchedits first online guidance
document on understanding and engaging
with the evolving NHS. This document is
enclosed in this issue of the HEALTHCARE
CounsellingandPsychotherapyJournal.
If you would like an electronic copy of the
guidance, or to view other guidance
documents available online, visit
www.bacp.co.uk/commissioning. These
documents will help you understand the
policy context, the new emerging NHS
structures and, crucially, how to engage. In
the meantime, here are some suggestions
for service managers and lead counsellors
to consider:
— Keep up to date with information on
national policy that affects local
commissioning.
— Develop local contacts to keep in touch
with how NHS reforms are impacting on
your locality.
— Contact local mental health leads and
commissioners; aim to understand their
perspective on the future of psychological
therapies.
— At present, it is not mandatory for
commissioners to choose AQP for
psychological therapies, but it may be in
the future. Therefore, as the guidelines are
already in place, utilise the opportunity
to get ahead and plan for this.
These are just some suggestions on
how to monitor the local impact of NHS
commissioning reform. This may prove
difficult in the current period of transition
and flux, but now is the time to establish early
relationships with key people in the CCGs
and advocate for your service and your
profession; simultaneously maintaining
excellence in clinical practice to show how
intervention through therapy can improve
individual and community wellbeing.
If you would like to discuss the NHS
Commissioning Project being undertaken
by BACP, and for further links and resources
that may be of assistance to you, please
contact Nichola Watson, project officer for
NHS commissioning, at nichola.watson@
bacp.co.uk
Acknowledgements:Thisarticlewas
writtenincollaborationwithLouise
Robinson,healthcaredevelopment
manageratBACP.ForLouise’supdateon
healthcaredevelopments,pleaseturnto
page7ofthisissue.
Commissioning
in the NHS
– so what’s new?
Nichola Watson outlines how
counsellors and psychotherapists
can engage in NHS reforms
A reassuring
consideration in all
this change is that, in
most areas, there is
time to get organised
BACP is taking a
proactive approach to
supporting members
through this transition