Janet Finucane

1. Janet Finucane
Senior Specialist Commissioning
Manager, Joint Commissioning
Team – (posh shopper!)

2. What I want to talk about
• Do a quick overview of the science of
commissioning
• Discuss two areas of work that sit between
our local communities and specialist
services
• Discuss some challenges for keeping
strong local links for services a step away
from GPs.

3. Shopping!
• Bought a car in
the last two
years?

4. Did you?
• Go back to the same
garage?
• Buy the same model as
last year?
• Pay the manufacturers
asking price?
• Are you pleased with the
car in terms of comfort,
speed and reliability
• Do you know if it was value
for money?

5. Commissioning ?
Buying services
Needs to be fresh
Quality
Meet need
vfm

6. Commissioning the car?
• Work out what you needed and how much it
would cost to run.
• Buy ethically
• Check carefully what other demands would be
placed on your budget
• Shop around a few garages first to work out who
had the best deals for the car you wanted
• Negotiate a good price including warranty and
servicing
Did you shop/commission what you needed…..

8. Example 1 - HMP
Needs
5000 pa
Ageing population
70% MH needs
High risk taking lifestyle
(tb,Hep,dental decay,
infectious diseases),
80% smokers
? Improve Health…….

9. Challenges
Security comes first
Staffing require CTC – takes 3 months
Required to provide equitable services to
community
Limited escorts out
Need to get services in and integrate back home
Service delivery long due to security inputs
High dna rates…high waiting lists (Links)

10. What we have
• Strong in house team of nursing, mh and
drugs staff
• Inpatient unit – 28 beds
• Primary care centre with practitioners
(dental, pharmacy, podiatry)

11. Some examples of what we have
bought and developed
• Telemedicine service offering A&E and clinics
• New dental service
• New anti coagulant service
• New integrated drug treatment service
• Stronger links with social care
• Increased smoking cessation
• Review of mental health services to link with
local pathways
• Chronic disease registers and support for older
prisoners

12. Developments link into our local
relationships and provisions
Will we still be able to link
as effectively into the
good will of our local
services
Post the transfer of our
community services
Will the working
relationships between
public health/prison/gp be
strong enough?

13. Can you take on Bariatrics?
• Budget based on last
years spend
• Obesity crisis
• Fern factor
• Contract established
but lots of last years
people still waiting!
• Pathway gaps
• NICE levels

14. Scope out problem
• Find out what bariatric surgery is
• Find out how many people need it
• Find out if we can afford it
• Find out what processes are in place to
monitor and deliver it
• Find out if we have users views

15. Local Bariatric Challenges
• Handling expectation and
Need
• Fit wit local services and
pathways
• Current system gives GPs
barrier and not direct NO
• Still need to commission
local dietetics service etc. ?