This document discusses the role of public health and commissioning librarians in supporting primary care commissioning in West Sussex, England. It provides an overview of the history of commissioning in the UK healthcare system and describes the current commissioning cycle. It also outlines the services provided by the West Sussex Knowledge & Libraries team and the role of the public health and commissioning librarian in supporting various stakeholders involved in primary care commissioning.
Making difficult decisions to ensure the future of quality health care for you.
A Derbyshire Dales District Council Area Community Forum presentation (October 2014) by Northern Derbyshire Clinical Commissioning Group
Dr Sharon Chadwick, Consultant in Palliative Care, Hospice of St Francis, Hertfordshire and Claire Nicell, Hospice Champion Educator working with Hospice
of St Francis, Peace Hospice Care and West Hertfordshire NHS Trust
Mobilising Evidence and Organisational Knowledge in the NHSCILIP
Sue Lacey Bryant (Senior Advisor, Knowledge for Healthcare, Health Education England) and Louise Goswami's (Head of Library and Knowledge Services Development, Health Education England) presentation to the CILIP 2017 Conference in Manchester #CILIPConf17
Health Education England (HEE) is driving the implementation of Knowledge for Healthcare which articulates an ambitious vision for healthcare library and knowledge services funded by the NHS. These services supply the evidence base to the NHS to make #AMillionDecisions a day. HEE is taking a strategic approach to mobilising evidence and organisational knowledge through policy and advocacy initiatives, by introducing new resources, tools and techniques and by empowering our workforce. Partnership working across all sectors, and including CILIP, is central to our success. The speakers will outline their approach, share experience and invite ongoing dialogue.
Making difficult decisions to ensure the future of quality health care for you.
A Derbyshire Dales District Council Area Community Forum presentation (October 2014) by Northern Derbyshire Clinical Commissioning Group
Dr Sharon Chadwick, Consultant in Palliative Care, Hospice of St Francis, Hertfordshire and Claire Nicell, Hospice Champion Educator working with Hospice
of St Francis, Peace Hospice Care and West Hertfordshire NHS Trust
Mobilising Evidence and Organisational Knowledge in the NHSCILIP
Sue Lacey Bryant (Senior Advisor, Knowledge for Healthcare, Health Education England) and Louise Goswami's (Head of Library and Knowledge Services Development, Health Education England) presentation to the CILIP 2017 Conference in Manchester #CILIPConf17
Health Education England (HEE) is driving the implementation of Knowledge for Healthcare which articulates an ambitious vision for healthcare library and knowledge services funded by the NHS. These services supply the evidence base to the NHS to make #AMillionDecisions a day. HEE is taking a strategic approach to mobilising evidence and organisational knowledge through policy and advocacy initiatives, by introducing new resources, tools and techniques and by empowering our workforce. Partnership working across all sectors, and including CILIP, is central to our success. The speakers will outline their approach, share experience and invite ongoing dialogue.
Health information pathways – the collaborative approach across public librar...CILIPScotland
Marianne Brennan, Development Officer, The Health and Social Care Alliance Scotland
Jane Milne, Customer Services Manager, Midlothian Council and Lead for Health and Wellbeing Strand of the Public Library Strategy
Alison McAllister, Systems and Support Officer, North Ayrshire Council
Death and dying - understanding the dataMarie Curie
Phil McCarvill, Marie Curie's Head of Policy and Public Affairs, presented at 'Improving outcomes at the end of life' on 9 July, 2013 in London.
He presented on the data from Marie Curie's report 'Death and Dying' which looks at variations on the provision, spending and identification of end of life services across the country.
It draws together and analyses data from the Marie Curie End of Life Care Atlas and other sources including the Nuffield Trust study and the VOICES survey of bereaved relatives.
For more information on commissioning, have a look at our website mariecurie.org.uk/commissioning or get in touch at servicedevelopment@mariecurie.org.uk
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Sharing and Learning Together to Deliver High Quality End of Life Care for All
Presentations from the Sharing and Learning Together to Deliver High Quality End of Life Care for All event held on
Tuesday 24 June 2014, Congress Centre, London, WC1B 3LS
#nhsiqeolcare
Public library universal health offer - Julie OldhamCILIP
The public library health offer:
• Trusted community space
• Assisted digital access
• Access to key communities and vulnerable groups • Health information and signposting
• National reading programmes
• Social reading and recreational activity
• Volunteering and engagement
As presented to lead a discussion at the first ever OpenCities conference held in Toronto, June 2007.
moar: http://thomaspurves.com http://opencities.ca
Health information pathways – the collaborative approach across public librar...CILIPScotland
Marianne Brennan, Development Officer, The Health and Social Care Alliance Scotland
Jane Milne, Customer Services Manager, Midlothian Council and Lead for Health and Wellbeing Strand of the Public Library Strategy
Alison McAllister, Systems and Support Officer, North Ayrshire Council
Death and dying - understanding the dataMarie Curie
Phil McCarvill, Marie Curie's Head of Policy and Public Affairs, presented at 'Improving outcomes at the end of life' on 9 July, 2013 in London.
He presented on the data from Marie Curie's report 'Death and Dying' which looks at variations on the provision, spending and identification of end of life services across the country.
It draws together and analyses data from the Marie Curie End of Life Care Atlas and other sources including the Nuffield Trust study and the VOICES survey of bereaved relatives.
For more information on commissioning, have a look at our website mariecurie.org.uk/commissioning or get in touch at servicedevelopment@mariecurie.org.uk
Transforming End of Life Care in Acute Hospitals PM Workshop 5: How to use th...NHS Improving Quality
Transforming End of Life Care in Acute Hospitals PM Workshop 5: How to use the revised and updated ‘Transform How to Guide’ presented by Maggie Morgan Cooke, Wendy Gray, NHS England
Sharing and Learning Together to Deliver High Quality End of Life Care for AllNHS Improving Quality
Sharing and Learning Together to Deliver High Quality End of Life Care for All
Presentations from the Sharing and Learning Together to Deliver High Quality End of Life Care for All event held on
Tuesday 24 June 2014, Congress Centre, London, WC1B 3LS
#nhsiqeolcare
Public library universal health offer - Julie OldhamCILIP
The public library health offer:
• Trusted community space
• Assisted digital access
• Access to key communities and vulnerable groups • Health information and signposting
• National reading programmes
• Social reading and recreational activity
• Volunteering and engagement
As presented to lead a discussion at the first ever OpenCities conference held in Toronto, June 2007.
moar: http://thomaspurves.com http://opencities.ca
Presentation to Brighton and Sussex NHS Library and Knowledge Service Journal Club on Rethlefsen ML, Farrell AM, Osterhaus Trzasko LC, Brigham TJ. Librarian
co-authors correlated with higher quality reported search strategies in general
internal medicine systematic reviews. J Clin Epidemiol. 2015 Jun;68(6):617-26.
Fenin en colaboración con el departamento comercial UK Trade and Investment, de la Embajada británica en Madrid, han organizado un foro empresarial dirigido al sector de tecnología sanitaria, con el objetivo de evaluar los sistemas de compras de los sistemas sanitarios de España y Reino Unido (NHS), y conocer las oportunidades de negocio que el NHS representa para empresas españolas de tecnología sanitaria.
LTC year of care commissioning early implementer sites workshop held on 1 December 2014. Featuring Dr Martin McShane, Rob Meaker and Renata Drinkwater.
LTC Year of Care Commissioning Model
Lesley A Callow, Delivery Support Manager - Long Term Conditions Year of Care Commissioning Model
NHSIQ
Fionuala Bonnar, Year of Care Programme Manager
LTC Year of Care benefits:
Improved outcomes and wellbeing:
Patients receive care that is better managed, more seamless across different care services and more needs focused.
Reduction in acute admissions to hospital; and shorter lengths of stay when these are required.
Clinical professionals contribute to a more holistic service for patients by working within an integrated patient-centred care plan
Local health and Social Care economies:
Provide care that delivers value for money and is better managed by integrated teams.
Incentive to improve services for patients
Improved joint working and shared responsibility for outcomes
Presented at the Our Hidden Lives: Publishing Everyday Diaries conference, 17th November 2004, organised by the Centre for Life History Research, University of Sussex
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The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
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The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
A Strategic Approach: GenAI in EducationPeter Windle
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1. Sussex by the sea: supporting
primary care commissioning
Erica Rae and Tom Roper
West Sussex Knowledge & Libraries
2.
3. West Sussex Knowledge &
Libraries
• Two physical sites, at Chichester and Worthing
• Support all NHS staff, whether acute, primary,
mental health, local authority, hospice…
– Head of Library and Knowledge Services
– Deputy Head of Library and Knowledge Services
– Public Health & Commissioning Librarian and Primary
Care Librarian
– Clinical Librarian and Knowledge Systems Librarians
– Library managers and library assistants
4. A brief history of commissioning
• 1991: purchaser-provider split, GP fundholding,
GP & locality commissioning
• 1995: total commissioning
• 1997: Labour elected, committed to end
fundholding
• 1999: fundholding abolished, PCGs (later PCTs)
established
• 2010: coalition elected
• 2011: CCGs
• 2012: Health and Social Care Act passed
9. Coastal West Sussex:
Locality areas and practices
• Adur
– 9 GP surgeries in Lancing, Shoreham-by-Sea, Sompting and
Southwick
• ARCH
– 22 GP surgeries in Arundel, Bognor Regis, Chichester, East
Wittering, Loxwood, Midhurst, Petworth, Pulborough, Selsey,
Southbourne, Tangmere and Yapton,
• Arun
– 6 GP surgeries in East Preston, Littlehampton and Rustington
• Cissbury
– 13 GP surgeries in Ferring, Goring-by-Sea and Worthing
• Chanctonbury
– 5 practices in Billingshurst, Henfield, Steyning & Storrington
10. Coastal West Sussex
• GP Practices
• One acute NHS hospital trust, two main
sites
• Six NHS community hospitals
• Over two hundred community nurses
• A wide range of community teams
• Over fifty NHS dental surgeries
• Around ninety-five community pharmacies
11. Some salient features
• Higher than average proportion of elderly people (20% over 65,
England 16%)
• Considerable health inequalities
• Poorer life expectancy in deprived areas
• Rising numbers of people with disabilities
• Rising numbers of people living longer with long term conditions.
• Alcohol-related hospital admission rates have continued to increase.
• Obesity affects all ages within the population
• c.180,000 adults obese, at increased risk of
– Diabetes
– Hypertension
– Coronary vascular disease
– Stroke
– Cancer
12. Key relationships for the CCG
• NHS Commissioning Board
• NHS Sussex and NHS South of England
• Providers
– Western Sussex Hospitals NHS Trust
– Sussex Community NHS Trust
• West Sussex County Council
– Joint Commissioning Unit
– Health and Wellbeing Board
• Patients and public
13. Public Health & Commissioning
Librarian
• Role of the PHCL Librarian
• Public Health and Commissioning –
What’s the difference?
• Service changes
• Commissioning Cycle/Intelligence Model
• Example searches
• Current Awareness
14. • The PCT – we’ve always been there!
• A change of service
• A change of customer base
• A new role for me
• The remit
• The practicalities
15. • Different teams, different approaches
• Major changes!
• Public Health will merge with Local
Government
• CCG developing their role
16. • Joined up services
• A culture shift
• Branching out into Local Government
• A new client base?
• Requiring new tools and methods
17. • So what do we do?
• And why do we do it?
• A couple of illustrations…
27. • Google –
For Public Health –
examples of other PCT’s health and wellbeing strategies
"alcohol strategy" pct or primary care trust
For the JCU –
information on the "Troubled Families Initiative”
"troubled families initiative" site:gov.uk
• New databases –
For Social Care information
Applied Social Sciences Index & Abstracts (ASSIA )
• Other resources –
Local Government Association website
National Centre for Social Research
30. • And finally...
• Marketing and Promotion –
Don’t wait for them to come to you
Current Awareness helps
Keep up to date yourself
Learn to speak their language
32. Useful websites
•Commissioning Handbook for Librarians http://commissioning.pbworks.com
•Local Government Association http://www.local.gov.uk/
•National Centre for Social Research http://www.natcen.ac.uk/
•NHS Commissioning Board Special Health Authority
http://www.commissioningboard.nhs.uk/
•NHS Information Centre for Health and Social Care
http://www.ic.nhs.uk/commissioning
•NHS Networks Commissioning Zone http://www.networks.nhs.uk/commissioning
•NHS Primary Care Commissioning http://www.pcc.nhs.uk/
•Quality:MK http://www.qualitymk.nhs.uk/
Editor's Notes
In this presentation, Erica and I will show how we support clinical commissioning in West Sussex. Erica and I are unusual, we think. We are both outreach librarians, dedicated to serving particular groups of users and embedded, or moving towards embededness, with those groups. Her job title is Public Health and Commissioning Librarian, while I am Primary Care Librarian. She divides her time between public health, now part of West Sussex County Council, and the Coastal West Sussex Clinical Commissioning Group, whose senior management congregate in the Causeway in Goring-by-Sea, while I work with GP practices and community NHS staff. Today I’m going to give you the dummy’s guide to commissioning and outline the West Sussex health economy, the context and the structures in which we operate. Erica will then give you a more postgraduate view of commissioning and describe some of the ways we have developed to reach this new, politically powerful, knowledge-hungry but sometimes hard-to-reach, constituency.
This is the prospectus that Library & Knowledge Services have produced to show how they can support and add value for CCGs. We have some copies if you’re interested.
West Sussex Knowledge & Libraries, which we represent, serves everyone across the whole of the local health economy. As well as us, the outreach wing, if you like, there’s a range of staff offering the full range of digital and print-based library services
Commissioning has been with us for some time. It’s a little like M. Jourdain’s prose, something that we have been doing unconsciously for all our lives. Seen chronologically, we have at least twenty years of experience of commissioning, from the introduction of GP fundholding in 1991, the total purchasing pilot in 1995, the 1999 abolition of fundholding and establishment of PCGs with the aim of progressing to PCTs, and then the recent history, post-election of the coalition and the Health and Social Care Act 2012.
Continuum of commissioning before the election of the current government One could argue that commissioning has been with us since the days of Hippocrates; certainly the act of writing a prescription for a patient is arguably an act of commissioning, and one can discern commissioning activity across a continuum, from direct care for an individual patient, to locality, community regional and national levels. This is how Smith and Mays saw it under the previous government. The chief change under the new act is that the regional level disappears altogether, though the role of the NHSCB area offices is at the moment still unclear and perhaps contested.
This is the rather rose-coloured view of the new NHS, with patients at the centre and safe in the embrace on the outermost circle of the SoS, the DoH and parliament. The purple circles represent organisations involved in commissioning care.
Erica will say more about this in a while, and the commissioning intelligence model
What of Sussex? At the highest level, NHS Sussex covers the whole of the counties of West and East Sussex and the city of Brighton & Hove, containing seven clinical commissioning groups or CCGs. The county of West Sussex contains three of these, Crawley and Mid-Sussex and Horsham and Coastal West Sussex CCG, with which we concern ourselves. Coastal, as we affectionately call it, is the largest, with a population of nearly half a million, served by 58 practices
The Coastal CCG area, as we affectionately know it, is further subdivided into five localities, ARCH, in the west of the west, being the largest. The CCG covers nearly 65% of West Sussex; serves a population of 482,100. With a range of local services Including: • 56 GP Practices • 1 acute NHS hospital trust • 6 NHS community hospitals • Over 200 Community Nurses And a wide range of Community teams • Over 50 NHS Dental Surgeries • Around 95 Community Pharmacies
1 acute NHS hospital trust 6 NHS community hospitals Over 200 Community Nurses And a wide range of Community teams Over 50 NHS Dental Surgeries Around 95 Community Pharmacies
Among the distinguishing features of the West Sussex health economy as a whole are: a higher than average proportion of elderly people (20% over 65, while the figure for England as a whole is 16%) considerable inequalities in health, both in terms of outcomes and wider determinants of health: poorer life expectancy in deprived areas There are projected to be higher numbers of people with disabilities and living longer with long term conditions. Alcohol remains highest priority in term of lifestyle risk factors - hospital admission rates have continued to increase. Obesity rates remain a concern – of all ages within the population, an issue for both children and adults. Current estimate of 180,000 adults obese in the county and at increased risk of conditions such as diabetes, hypertension, coronary vascular disease, stroke and cancer. Taken from the JSNA and the Health and Wellbeing Strategy
CCGs have to manage a complex web of relationships with other organisations. As well as the member practices, these are the key ones for the Coastal CCG
Well, Good afternoon everybody, & thank you all for coming to our session today to hear about our experiences in supporting primary care & commissioning As Tom has outlined, my name is Erica Rae & I am Public Health & Commissioning Librarian for West Sussex Knowledge & Libraries This is a list of what I hope to cover during the session, & hopefully there should be some time at the end for questions So I’ll explain – A little bit about my role and how I perform it The differences between the two services I support, & changes that are taking place We’ll also take [another] look at the Commissioning Cycle & Commissioning Intelligence Model & how they define the information needs of our users Some sample searches And how Current Awareness is being used as a ‘bridge’ for marketing and developing the service
My predecessor was librarian for the PCT in it’s many incarnations for 25 years until her retirement last year With that, and various other organisational changes in the library service at that time, it gave us the chance to bring the role more up to date Around the same time the Public Health team moved from PCT headquarters in Worthing to new offices in Chichester, prior to their integration with West Sussex County Council And we also saw the emergence of the Clinical Commissioning Group (CCG) “Coastal West Sussex Federation” who stayed at Worthing So we morphed the PCT librarian role into my new one, as a ‘roving librarian’ With a remit to provide library services to both the teams on an outreach basis So I now spend my time travelling between the two sites, ‘hot-desking’ with my trusty laptop, based with, and embedded in, the teams rather than in the library
It quickly became clear that there are some differences between the teams I work for, both in their attitude & approach Reflecting, I think, the various stresses & pressures on them as they move forward Public Health are preparing to merge with West Sussex County Council (WSCC), when they’ll become Local Government employees, & no longer NHS So they’re feverishly preparing for their transition whilst still trying to deliver ‘business as usual’ – And have been incredibly grateful for my input! Meanwhile the CCG have been grappling with clarifying & developing their role as a support service to GP Commissioners – Whilst getting to grips with the fundamental shifts that will be required in delivering Community Health Services And have found it harder to accept my presence & understand how my input can help
There’s also a third strand to my work – Supporting staff of the ‘Joint Commissioning Unit’ (JCU), a collaborative team of commissioners made up of NHS staff from the PCT, and the local authority staff of West Sussex County Council This has demanded what we think is quite a new & novel approach, requiring a fairly fundamental shift in our own thinking, & delivery of services to a more integrated customer base It seemed illogical to be offering library services to only the NHS half of this team so we’ve now started to think of the County Council staff as a potential client base as well, and have done some literature searches for them This has proved to be an interesting and potentially powerful move, as the service has been warmly received And has also required purchase of ASSIA, a new database for searching for Social Care information, a lot of ‘Googling’, & investigating other potential sources of Local Government information
So what do we actually do, in terms of evidence and information-finding, and why do we do it? To answer that, I’m going to look in a little more detail at the diagrams we referred to earlier, the Commissioning Cycle, & the Commissioning Intelligence Model
Public Health are a very ‘evidence-based’ team, basing a great deal of their work on research findings, with evidence underpinning much of their output and commissioning decisions Whilst evidence review is also very much the case for the CCG, it tends to form a smaller part of the overall whole that is the ‘Commissioning Cycle’ [The NHS Information Centre provide a rather nice little interactive tool to illustrate this at http://www.ic.nhs.uk/commissioning ] And we’ll tend to be involved at the Planning Stage , rather than the active Procurement one, or during Monitoring and Evaluation of their contracts
If we now look at the Commissioning Intelligence Model, [available at The NHS Commissioning Board website http://www.commissioningboard.nhs.uk/2012/02/03/commissioning-intelligence-report/ ] ..we can begin to see in more detail where fit in in terms of evidence or information-finding It’s a rather complicated diagram with lots of detail about the tools & types of services a CCG needs for the commissioning process Centred around a number of questions that they need to ask And is very ‘data-driven’ – primarily about the numbers But if we look at some of the questions in close-up we can begin to see how some of them are relevant to us and how we can contribute
So, for example – Question 1. How healthy is our population? Where they ask questions such as ‘Who would benefit most from a disease management programme’
Question 4. How do we compare? For example ‘do current pathways reflect evidence-based good practice’
And Question 6. How could things be better? Such as ‘Do our patients receive the most appropriate and cost-effective medicines’
Some of these types of questions will seem familiar to health librarians and easy to answer with traditional resources But others are more challenging and require us to ‘think out of the box’ a bit more to find relevant information, as they don’t find their way in to the formal literature Something that they particularly like to see, for example, is ‘How have others done it?’ – existing examples of, for instance, service specifications, service redesigns, case studies, well-being strategies, etc, from other organisations (PCTs, Acute Trusts)
Here’s part of a search in HDAS on ‘MSK Hubs’ – a new idea for a centralised Musculoskeletal triage and referral service that’s been successfully implemented elsewhere in the country It’s a bit faint but hopefully you can see the list of big fat ‘zeros’ in the Results column...
So here’s what we did on the internet to try & find examples of other redesign projects & service specifications – Examples straight away of some Case Studies...
And some service specifications Using the search string msk hub "service specification" in Google And if we add in the advanced search method restricting the domain to nhs.uk we start to find a lot more! (Find more! using msk hub "service specification" site:nhs.uk )
Similar searches for Public Health, & the JCU, have involved Googling for other PCT’s health and wellbeing strategies – "alcohol strategy" pct or primary care trust Information on the Government’s recently announced "Troubled Families Initiative" "troubled families initiative" site:gov.uk And we’ve also recently invested in ASSIA, a new database, (Applied Social Sciences Index & Abstracts) to add to our arsenal of tools for searching for Social Care information As well as investigating other resources such as the Local Government Association website & National Centre for Social Research
There are also some really useful ‘ready-made’ resources other enterprising libraries have created The Commissioning Handbook provides a wealth of information & advice on ‘how to do it’
Anne Gray’s Milton Keynes based website is an excellent source for identifying Hot Topics & subscribing to updating bulletins
And finally... To market & promote the service, we’ve found that – Taking the service out to the teams rather than waiting for them to come to you is essential They won’t necessarily equate traditional ‘clinical-based’ information with what we can do, so it helps to ‘learn their language’ I have no compunction in pushing current awareness at them instead of them asking for it It’s a good marketing tool & gets you known – I’ve had people come back to me after receiving something unsolicited
Creating bespoke services that show you understand their world are useful For example PubComm is a Netvibes site I created as a ‘one-stop shop’ – a dedicated current awareness portal for Public Health & Commissioning information at www.netvibes.com/pubcomm (just Google ‘netvibes pubcomm’)
And last but not least, some useful websites – Commissioning Handbook for Librarians http://commissioning.pbworks.com Local Government Association http://www.local.gov.uk/ National Centre for Social Research http://www.natcen.ac.uk/ NH'S Commissioning Board Special Health Authority http://www.commissioningboard.nhs.uk/ NHS Information Centre for Health and Social Care http://www.ic.nhs.uk/commissioning NHS Networks Commissioning Zone http://www.networks.nhs.uk/commissioning NHS Primary Care Commissioning http://www.pcc.nhs.uk/ Quality:MK http://www.qualitymk.nhs.uk/