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Clinical Commissioning : What does it mean for you?. What are the main things to change?. Scrap PCTs and SHAs in April 2013 Slash NHS management costs by 45% Hand majority of commissioning budgets Clinical Commissioning Groups, headed up by GPs and Practice staff, not managers

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what are the main things to change
What are the main things to change?
  • Scrap PCTs and SHAs in April 2013
  • Slash NHS management costs by 45%
  • Hand majority of commissioning budgets Clinical Commissioning Groups, headed up by GPs and Practice staff, not managers
  • Public Health to move to Local Authority – overseen by new body ‘Public Health England’
  • Patient to be at the heart of all decision-making – ‘no decision about me without me’






Future NHS Structure following NHS Reform



NHS Commissioning Board

Public health service

Monitor (economic regulator)


Regional outposts


~250 foundation providers

250+ GP commissioning consortia

Health and well-being boards2

Local partnership


Local HealthWatch


Patients and public

2 Local authority link and representation

key changes why is it changing
Key Changes – why is it changing?
  • No more ‘top-down approach’ – less bureaucracy
  • Make NHS more responsive to patients
  • Stimulate provider market – increased competition leading to increased quality and productivity
  • GPs are best placed to understand patients’ needs
  • Save £5bn by 2014/15 and £1.7bn per year thereafter
  • More investment in clinicians, not on managers
what s happening locally
What’s happening locally?

Old Structure

PCT (Commissioner)

Provider Arm








GP Practices


what s happening locally1
What’s happening locally?

Current Structure


Wirral CCG

GP Practices



and Wirral




Clinical Commissioning Groups (formerly Consortia)






why one ccg
Why one CCG?
  • Department of Health requirement for a CCG to be ‘geographically defined’
  • The three consortia will work independently and plan services that are in line with their own patient needs.
  • Will retain own arrangements for patient engagement and involvement.
  • will do things Wirral-wide where more appropriate – like ambulance services, and emergency care
our responsibilities
Our responsibilities

We will retain our autonomy as a Consortium

Our Consortium

  • Most hospital activity
  • Prescribing
  • Community Services
  • Clinical Engagement
  • Patient Engagement
  • Training and Development
  • Primary Care Mental Health
  • Local commissioning schemes

Wirral CCG

  • Secondary Care Mental Health
  • Children’s Services Governance / Corporate Management
  • Continuing Healthcare
  • Out of Hours
  • Ambulance Service
  • Secondary Care Cancer
  • Hospices & end of life care
  • Specialist Commissioning
our duties
Our duties

- Improve access and choice

  • Focus on quality and safety
  • Outcomes not processes
  • Patient-centred approach
  • Make best use of resources

NHS Providers can be healthcare Trusts, voluntary sector and community groups, private sector companies, charities....

Any organisation that PROVIDES healthcare services FREE at the point of delivery

“Commissioning in the NHS is the process of ensuring that the health and care services provided effectively meet the needs of the population.  It is a complex process with responsibilities ranging from assessing population needs, prioritising health outcomes, procuring products and services, and managing service providers.”

clinically led commissioning
Clinically led Commissioning

Engagement with our patients and stakeholders is integral to every stage of our commissioning process


Service review and development of service specifications

Contract monitoring

our approach
Our Approach
  • Innovative – work with a range of providers
  • Commission through Any Qualified Provider
  • Services in the community, on patient doorsteps wherever possible
  • Engage with patients and practices in all that we do
what is peninsula health
What is Peninsula Health?
  • Former government encouraged development of different providers
  • Partnership between 25 practices and Virgin Care
  • Developed range of community services greatly improving access and choice
  • No profit to practices – any profit made invested into Patient Trust – for use on patient care by 5 Patient Trustees
  • Is one of many providers that delivers services to our patients
our achievements
Our Achievements

Patient Engagement



Council and Executive


Service Development

Minor Injury and Illness


Additional Investment in Physio

Podiatry, Mental Health

Admissions Prevention

Clinical Engagement

Clinical Leads and Portfolio


GP, Practice Manager, Nurse


Online forum and website

Management of Resources

Track record of staying within

1% of total budget allocation

Through effective


we have freed up

£5m in 2011/12

integrated care
Integrated Care

Committed to working with our partners to ensure integrated and seamless journeys for our patients

our challenges
Our Challenges
  • Levels of deprivation with health inequalities
  • Need patients to take responsibility for resources – eg DNA appointments and medicines waste
  • Ensuring all practices engaged so that commissioning is clinically driven
  • Reaching the unreachable patients
what s next
What’s next?
  • Unplanned and Elderly Care
  • More funding for dementia care and identification of dementia
  • Nursing home visiting
  • Extension of Minor Injury sites
  • Community Services
  • Gynaecology
  • Dermatology
  • Diabetes
  • More investment in Physiotherapy and Podiatry
  • Access to diagnostics
  • Long Term Conditions
  • Support for housebound patients
  • Telehealth
  • Integration between health and social care
  • Mental Health and Substances
  • Increase funding in Primary Care Mental Health in practice
  • Explore complex case service involving drug and alcohol services
  • Community Alcohol support