1. Practice development Workshop Commissioning Finance 09 February 2012

2. Workshop Goals and Topics • Understanding CCG budgets what is new? • Financial environment and clinical decision making • Understanding linkage between activity, Finance & QIPP • Financial communication between CCG and its practices • Implications for CCG and member practices • Performance management at practice level

3. What’s Different Now? Source: Kinds Fund, “Clinical commissioning: what can we learn from previous commissioning models?”, 2010

4. Business Fundamentals of a CCG Health Finance 101 Revenue Resource Limit = Clinical Service Costs + Running Costs Units x Unit Price Direct + Shared Allocation for CCG to Spend Core Functions CSO & Leeds Shared National Tariff Local Tariff Block Arrangements Population Health Management Utilisation and Market Management Breakeven Devolved to practices Linked to COMPACT

5. Quality, Innovation Productivity & Prevention (QIPP) • NHS has to save £20bn by 2014/15 • No real growth in the NHS for the next decade • Growing demand and ageing population • Cost pressures (new drugs & treatments) • Impact on the level of service if we don’t do things differently • Practices are a key innovator and implementer of QIPP programme

6. Payment by Result (PbR) – Why Important to GPs? • Contracts will be agreed at CCG level with providers, 90% PbR • Appropriate treatment in the right setting • Focus on ensuring pathway compliance • Practice will receive commissioning information – activity, finance and referrals – and will work with CCG to interpret and take actions • COMPACT – Will be partially linked to successful compliance and implementation of pathways and maintaining budgetary control PbR Development • Being extended beyond secondary care • Mental health • Ambulance • Community Services

7. Implications for CCG and member practices • CCG to balance its books need to work with member practices to operate within allocated budget. • Collaborative working to achieve financial balance • Practice based budgets • Activity & finance information sharing and communication • Performance management & Compact • CCG financial position will impact on the level of services that can be commissioned by a CCG

8. Checkpoint Health Finance 101 • Break into 4 groups • Each group has been assigned a finance and Activity scenario • In your own group, work through the following: • Discuss insights and follow up questions / actions • Present back to broader group

9. Handouts Identifying issues & potential actions

10. Group Exercise: Scenario 1 Handout (Practice – I)

11. Group Exercise: Scenario 1 Handout (Practice – I)

12. Group Exercise: Scenario 2 Handout (Practice S)

13. Group Exercise: Scenario 2 Handout (Practice – S)

14. Handouts Understanding Accountability

15. Group Exercise: Scenario 2 Handout • Fill in some answers?