The document discusses commissioning cycles and processes. It defines commissioning as assessing local needs, designing appropriate services, and achieving outcomes through public, private, or nonprofit providers. Commissioning also involves specifying, securing, and monitoring strategic services to meet people's needs. The document outlines the commissioning framework and roles of clinical commissioning groups, public health, and NHS England in the United Kingdom's health system. It emphasizes the need to transform commissioning to address rising costs, demand, and public expectations with reduced budgets. The commissioning cycle aims to improve health, quality of life, recovery from illness, patient experience and safety, and reduce health inequalities.

1. Getting to grips with the
commissioning cycle - working with cycles,
processes and potential to innovate
Ali Jan Haider
DHEZ Presentation – 30th
June 2016

2. ‘what is commissioning?’

3. Question
“Commissioning is the cycle of assessing the
needs of people in an area, designing and
then achieving appropriate outcomes. The
service may be delivered by the public,
private or civil society sectors”.

4. Question
“Commissioning is the process of specifying,
securing and monitoring services to meet
people’s needs at a strategic level. This
applies to all services, whether they are
provided by the local authority, NHS, other
public agencies, or by the private and
voluntary sectors.”
Institute of Public Care Commissioning Framework

5. Contracting and Purchasing
PurchasingPurchasing
The process of acquiring
goods, works or
services from (usually)
external
providers/suppliers
and managing these
through to the end of
contract.
ContractingContracting
The process of
negotiating and
agreeing the terms of a
contract for services,
and on-going
management of the
contract including
payment and
monitoring.

6. Why do we need to transform
how we Commission?
10 years of
increased spend
Increase in
demand
25% to 40%
budget cuts
Rising public
expectation
6September 2011

7. THE BIG PICTURE
(If you think its bad now …)
A call to action (2013)

8. BRADFORD DISTRICT CCG FINANCIAL PLAN
WHERE WE SPENT OUR MONEY IN 2013/14
TOTAL SPEND IN 2013/14 WAS £400.1M
BREAK-EVEN
2013/14 IN YEAR RESOURCES AVAILABLE WAS £400.1M
£228.7M
£18.4M
£35.6M£14.5M
£6.2M
£2.9M
£53.4M
£40.4M
Total Services
Acute Services
Continuing Care Services
Mental Health Services
Other Programme Services
Running Costs
Primary Care Out of Hours
Primary Care Prescribing
Primary & Community

9. Who commissions what in health?
• 3 Clinical Commissioning Groups (CCGs)
– Bradford City (BCCCG)
– Bradford Districts (BDCCG)
– Airedale, Wharfedale & Craven (AWCCCG)
• CCGs are: NHS bodies, membership
organisations, clinically led; plan and buy
healthcare services for local people
• Public Health (transferred to the Local Authority
in April 2013)
• NHS England
CCGs NHSE Public Health
 emergency and urgent
care (including: A&E,
ambulance and out of
hours services)
 community health
services
 maternity services
 planned hospital care
 rehabilitation services
 healthcare services for
people with mental
health conditions or
learning disabilities
 continuing healthcare
• primary medical care
• community pharmacy
• dental services
• NHS sight tests
• specialised services and
high security psychiatric
services
• prison health and
services for military
personnel
• some public health
services
• sexual health services
• the Healthy Child
programme
• local programmes to
promote activity, healthy
eating and weight
management
• drug and alcohol misuse
services
• stop smoking services
• local programme to
prevent accidents or
reduce deaths, for
example, winter planning

10. DH Commissioning Model

11. IPC model for joint strategic commissioning
& purchasing
11

12. Task
Grit Commissioners
Bradford expects a tough winter 16/17 and a very heavy downfall of snow;
You have been tasked with commissioning grit for 16/17 for the whole of
Bradford District:
•How do you work out how much grit would be needed?
•Which areas would you prioritise for gritting?
•How would you ensure good value for money?
•Why is quality and safety important?
•How do you promote self-care and prevention?

13. Question
How does the commissioning cycle
bring health and well-being to life?

14. THE BIG PICTURE
Mission impossible?
• Prevent people from dying early
• Enhance the quality of life for people with
long term conditions
• Help people recover following episodes of ill
health or following injury
• Improve patient experience
• Improve patient safety
• Reduce health inequalities

15. THE BIG PICTURE
Great expectations!
• A health service – not just an illness service
• Give patients greater control over their health
• Harness transformational technologies
• Exploit potential for transparent data
• Move away from ‘one-size fits all’ model of care
• Unlock healthcare as a key source of economic
growth

16. THE BIG PICTURE
The Wizard of Oz
• If I only had a brain
– Integration of health and social care
• We must make real connections
• If I only had a heart
– Care closer to home
• Locally delivered, culturally sensitive services
• If I only had courage
– Self care
• We have to let go so that the people (aka ‘patients’)
become the experts (or at the very least – make shared
decisions!)