Commissioning
Commissioning in the NHS is the process by which it ensures that health and care services are provided most effectively and meet the needs of the population. It is a complex process with responsibilities ranging from assessing population needs and prioritising health outcomes, to procuring products and services, and managing service providers.
GP Consortia
Fifty two groups of GP practices from across England will become the first wave of GP consortia under 'Liberating the NHS' commissioning plans. LOCSU and the Optical Confederation urge all LOCs to take steps to build relationships with the leaders of their local consortia and will provide additional support to LOCs for this purpose.
The so-called 'pathfinder' consortia will cover 12.8 million patients across England, around a quarter of the country's population. They will road test the ability of GPs to take over from PCTs, essentially. The pathfinder sites range from a single GP practice to a consortium made up of 75 GP practices covering a population of over half a million.
The government's objective of establishing pathfinders is to empower pioneering groups of GP practices and their local commissioning partners to press ahead with commissioning care for patients. This strategy presents a huge opportunity for LOCs to get eye care on the local agenda.
Details of these initial pathfinders, including the corresponding LOCs, are in the excel document on the right of this page. Also available is a model presentation for LOCs to give to GP commissioning groups as an introduction to local eye care services and the potential for improving pathways, along with accompanying presentation notes.
LOCs in the pathfinder areas should take this opportunity to congratulate the leaders of the approved consortia, and request a meeting to deliver this presentation if they haven't already done so - a model letter to the consortia lead is available on the right of this page.
LOCs should share Professor Nick Bosanquet's report 'Liberating the NHS: Eye Care, Making a Reality of Equity and Excellence' with GP colleagues, to demonstrate the benefits of expanding community eye care services. To access the Bosanquet report, please click Bosanquet Report
Any LOC officers who need advice on engaging GP colleagues should get in touch with LOCSU as soon as possible and please do send us an update of the reaction you receive when you have contacted and/or presented to your local consortia so that we can share your experiences with other LOCs
Commissioning Made Simple
It is important that LOCs/ROCs understand the commissioning process from the PCT or Health Board's point of view. It is only by understanding the pressures that commissioners work under and what their criteria for success are, that LOCs/ROCs will learn how to tailor their tenders and business plans appropriately. LOCSU has produced an information leaflet explaining the commissioning process which you can access by clicking here
Department of Health - Commissioning Toolkit for Community Based Eye Care Services 2007
The Department of Health launced its toolkit for community based eye care services in January 2007. This toolkit, emerging from the General Ophthalmic Services Review, builds on the work of the Eye Care Services Steering Group and their pilot eye care pathways. It is intended to offer practical advice for Primary Care Trusts and practice based commissioners on commissioning community based eye care services. The toolkit is available as a pdf document to the right of this page or click here for more information on the Department of Health website.
NHS Primary Care Contracting - Community Eye Care Services: Review of local schemes for low vision, glaucoma and acute care 2007
This document is a review of local examples of community eye care services. It was part of the Department of Health's on-going programme of support for community eye care services in partnership with NHS Primary Care Contracting. It complements and sits alongside the Department of Health's 'Commissioning Toolkit for Community based Eye Care Services', referred to above. The PCC review document supports the delivery of key Department of Health policy objectives for both the commissioning and provision of high quality local services, closer to where patients live, moving appropriate primary care services outside the hospital setting, and providing greater choice and accessibility of services to patients. Please click the pdf document to the right of your screen for a copy of the review.
Department of Health / NHS Primary Care Contracting - Step-by-Step Guide to Commissioning Community Eye Care Services 2007
The purpose of this guide is to provide information and practical tools for PCTs and Practice Based Commissioners as they commission enhanced primary eye care services. It complements and builds on the two publications listed above - the Department of Health 'Commissioning Toolkit for Community based Eye Care Services' and the NHS Primary Care Contracting 'Review of Local Schemes for Low Vision, Glaucoma and Acute Care'. PCC states that while the guide was designed primarily for managers with commissioning support responsibillty at Practice Based Commissioning (PBC) level and commissionig managers in PCTs, it will also be of interest to community optometrists and LOCs - in fact all those involved in the delivery of local eye care services. The guide is available in pdf format to the right of this page.
Commissioning Enhanced Optometric / Optical Services
Please click here for information on the support and advice which LOCSU makes available to LOCs/ROCs who wish to get involved in the development of enhanced services locally.
NAPC Commissioning Guide
The National Association of Primary Care (NAPC) has recently published a very helpful 'Essential Guide to GP Commissioning' which LOCSU would encourage all members of the optical professions to read. The guide can be found on the right hand side of this page.
The 'Essential Guide to GP Commissioning' is intended as an introduction to 'Liberating the NHS', exploring the challenges and opportunities the NHS reforms will bring. Importantly for all of the healthcare professions the document uses the term inclusive commissioning, highlighting the need for GP Commissioning Consortia (GPCC) to engage other professions as well as patient and public if they are to become successful organisations.
Chapter 1 provides a useful overview of the key changes proposed by the NHS white paper 'Liberating the NHS'.
Chapter 2 goes on to explain the NHS Commissioning Cycle and how it will be affected by the changes. It stresses that a basic understanding of the commissioning process will become increasingly important but the level of involvement of individuals will vary from validating clinical activity information to becoming the Accountable Officer for the consortia. Practitioners in both primary and secondary care are encouraged to consider how they can get involved to ensure inclusive commissioning.
Chapter 3 examines The Essential Building Blocks of GP Commissioning ie. individual components that will be required to underpin effective GP commissioning. This chapter includes advice on Representation of Practices and Clinical leadership, as well as Understanding Budgets and Risk and achieving Financial Control. GPCC are advised to consider their current in-house capabilities and resource and to decide whether there are any support services they need to develop or procure and how engagement of various stakeholders may be helpful.
Chapter 4 focuses on Working Together and it is this concept of inclusive commissioning which brings a real opportunity for the optical professions at a local level. The guide states that commissioning will require robust involvement of patient, public, voluntary groups and clinicians from across the system. Given the requirement for competition, consortia will not be allowed to give exclusivity to any one provider but should ensure that the necessary knowledge is built into pathway design from the outset. Hence it is crucial that LOCs enter a dialogue with GP groups as soon as possible to ensure the voice of optometry is represented in any discussions around eyecare services.
Chapter 5 illustrates the Timeline that has been drafted to indicate when the various key stages of change will take place assuming that the proposals are confirmed as policy.
Chapter 6 'How can we start now?' outlines the action that needs to be taken by GP practices to make the most of the transition period. GPCC are to be established in shadow form initially to allow the development of relationships and a shared understanding/vision. The guide specifically advises the GPCC to engage with the representative bodies of local healthcare clinicians eg. LOC to help them succeed. GPCC are being encouraged to understand activity, identify commissioning needs and drive service redesign in preparation for when they take over the local healthcare budget. LOCs must seize the opportunity and ensure that their local GPCC are aware of the role that Local Enhanced Services can play in the redesign of local eyecare pathways.
LOCSU and the Optical Confederation are working with the clinical leaders of the healthcare professions via various NHS Networks to develop and share best practice in clinical commissioning and engaging the emerging GPCC but it remains vitally important that our LOCs build relationships at a local level and we would ask any LOC who needs help with this to contact Jacque Hudson as soon as possible.
