Looking at the evidence base for healthcare commissioning decisions. HLG conference Scarborough Sept 2016

1. Evidence based commissioning -
now and moving forward
Anne Gray, Knowledge Officer, Arden & GEM CSU
HLG Conference September 2016

2. What is commissioning?
• Commissioning is the process of procuring health
services.
• It is a complex process, involving the assessment
and understanding of a population’s health needs,
the planning of services to meet those needs and
securing services on a limited budget, then
monitoring the services procured.
[Faculty of Medical Leadership and Management, 2012]

3. What evidence do commissioners need?
• Scope need
• Data analysis
• Map the current
service
• Proposed service
model and
pathways
• Business case
• Implementation/
monitoring
[http://www.epilepsytoolkit.org.uk]

4. A “plurality” of sources
[Swan 2012]

6. Analysis of items in 4 Knowledge@lerts July 2016
• 20 - “expert” groups (Kings Fund, Nuffield Trust)
• 13 - NHS England/DH/PHE
• 10 - clinical peer groups (Royal College, Diabetes UK)
• 6 – Guidelines/standards (NICE,CQC,NHS Improvement)
• 5 – Local Government Association
• 3 - case studies (CCG board papers, magazines)
• 1 – peer reviewed journals

7. Looking for the evidence
What the research says:
• Commissioners look for themselves or rely on
colleagues, email discussion lists & alerts
• NHS sources are constantly changing and confusing
• Difficult to find commissioning/ management evidence
(exception – public health team)
• Don’t ask the library unless they have had previous
contact
• Library staff also found it difficult
[Edwards 2013, Wye 2015]

8. [Wye et al. 2015, Wilson 2016]
Using the evidence

9. A commissioning librarian
• Service model to help my customer
• Searching skills to identify the plurality of
evidence
• Report formats to meet the business need

10. Lessons learnt – Know your customer
• What is business critical?
• Speak the language
• Understand national and local drivers
• Tailored service
Rather than merely searching for relevant articles,
Anne reflected on the problem areas, searched
for evidence of a range of successful
interventions achieved elsewhere and provided a
new measurable solutions for the CCG to adopt.
This saved me time and added real value and a
new angle of approach. CCG Director

11. Lessons learnt – Searching
Health Serv Deliv Res

12. Lessons learnt – Synthesis&Summary
• Highlights …with an overview but also a link so you
can do into more depth if interested
• For busy people, as we all are, the snippets are
great as you don’t have to wade through a whole
load of words to understand what the info is about
• Having everything in one email instead of having to
remember where I saw this that and the other!!!
[Ass Dir CCG]

13. Existing resources
• For commissioners:
– Alerting services
– Map of Medicine
– Evidence for Success: The guide to getting evidence and using it
(Knowledge Translation Network Scotland)
– Evidence Toolkit (Avon Primary Care Research Collaborative)
– Commercial evidence services eg CSUs, Baysian
– Embedded librarians / Library services
• For Librarians
– Commissioning Handbook for Librarians
– Mailing lists

14. Under development
• Learning Zone (KfH)
• Evidence analyst pilot (Avon Primary Care
Research Collaborative)
• Grey literature searching (UK Health Forum)
• Synthesis/summary training (KfH)

15. Moving forward with STP/ Carter
• What can your library build on?
• How can you work with other libraries?
• What can you do next week?

16. Bibliography• Faculty of Medical Leadership and Management, 2012
http://www.nhs.uk/NHSEngland/thenhs/about/Documents/Commissioning-FINAL-2015.pdf
• Epilepsy Commissioning Toolkit http://www.epilepsytoolkit.org.uk/
• Swann J et al Evidence in Management Decisions (EMD) NIHR Health Services and Delivery
Research programme; 2012. http://www2.warwick.ac.uk/fac/soc/wbs/projects/emd
• Gkeredakis and Roginski The need for clarity in evidence based commissioning 23 May, 2011
• Wye et al. BMC Health Services Research (2015) 15:430 http://www.biomedcentral.com/1472-
6963/15/430
• Wilson PM, Effects of a demand led knowledge translation service on the uptake and use of
research evidence by NHS commissioners compared with lower intensity untargeted alternatives.
HS&DR - 12/5002/18 http://www.nets.nihr.ac.uk/projects/hsdr/12500218
• Edwards et al Explaining Health Managers’ Information Seeking Behaviour and Use. Final report.
NIHR Service Delivery and Organisation programme; 2013)
http://www.nets.nihr.ac.uk/projects/hsdr/081808243
• Evidence for Success: The guide to getting evidence and using it (Knowledge Translation Network
Scotland) http://www.evaluationsupportscotland.org.uk/resources/270/
• Evidence Works (Avon Primary Care Research Collaborative) (Avon Primary Care Research
Collaborative, AHSN, NIHR CLAHRC West http://www.nhsevidencetoolkit.net/
• Commissioning Handbook for Librarians (NHS Librarians)
http://commissioning.libraryservices.nhs.uk/
• KfH Learning Zone http://kfh.libraryservices.nhs.uk/learning-zone/specialist-and-technical-skills/