Agenda item

This report provides the Health & Wellbeing Board (HWB) with:

·         An understanding of the overall development process and the underpinning principles

·         A summary of our key areas of commissioning intent for 2014/15 and their strategic fit

·         A summary of key strategic challenges

·         How these challenges determine our focus for 2014/15

·         A summary of further opportunities for involvement

·         Sight of the proposed content and structure of the commissioning intentions document

·         Some key questions for consideration.

Dr Tim Spicer presented the report on the CCG’s Commissioning Intentions 2014/2015. Whilst the commissioning intentions were published on an annual basis, the process was ongoing, with strategic objectives being developed over a number of years, for example patient involvement in overall care. The commissioning intentions were derived from the Joint Strategic Needs Assessment (JSNA), but there were multiple drivers beyond the JSNA such as the Shaping a Healthier Future (SaHF) re-configuration proposals.

The report set out the basis for developing the commissioning intentions and how these would be developed. Dr Spicer stated that QIPP (Quality, Innovation, Productivity and Prevention) had to be achieved annually, and savings were in the region of 5% per annum. All stakeholders would be involved to a greater extent in developing commissioning intentions over time.  The report set out the engagement with individuals and teams currently.

The report also set out the timeline for developing commissioning intentions and the key milestones. The key strategic challenges includes meeting the needs of the population as identified in the JSNA and ensuring measurable changes in outcomes across the HWB priorities. A table illustrated how the commissioning intentions themes had structured the 2014/2015 service delivery and their fit with the key strategic drivers.

The CCG was currently working with stakeholders to update each of the key areas of the 2013/2014 commissioning intentions. An unscheduled care update had been provided as a draft example.  Dr Spicer stressed the importance of patient empowerment.

Councillor Ginn opened the discussion on alignment of commissioning between the Council, CCG and Public Health and joint commissioning where appropriate. It was suggested that the starting points should be the strategic fit of the CCG commissioning intentions with the  HWB strategic priority areas. There needed to be clarity about how resources could be re-deployed to bring about change and the barriers.  

The key strategic challenge would be to ensure measurable changes in outcomes across the HWB priorities, to be delivered within the context of a recurring QIPP gap and future comprehensive spending round. Joint commissioning of services could also deliver best value for money.

Councillor Ginn referred to Public Health commissioning and procurement and the need to cross reference with the CCG commissioning intentions. The re-procurement timetable was phased over three years and this was being challenged in view of the need to integrate with co-commissioners and to develop a framework against which commissioning outcomes could be measured.

Dr Spicer referred to the October timeline for refining/developing commissioning intentions and ensuring final alignment with the with the JSNA refresh and fit with HWB strategy to achieve required changes. Currently there were block contracts with providers, which were difficult to relate to outcomes and which aspect had brought about change in health status.

Members acknowledged the need to move towards an overarching commissioning plan, and that areas on which to focus could be considered at the HWB workshop.

Councillor Ginn referred to the transfer of public health to the Council and the  issues of finance and service gaps between providers. The true cost of services previously  had been covered up by block contracts, and were difficult to investigate if not a stand alone service.

Mr Christie stated that some joint commissioning arrangements were not absolutely right and that H&F CCG was talking to colleagues to agree alignment. Dr Spicer added that overall there were more similarities than differences, but frequently there were different processes for something not materially different.

Dr Brambleby queried what the CCG would achieve in one year in terms of quality. Dr Spicer responded that: engendering a change in patient experience was important; patient access to their medical records and involvement in care plans; and a reduction in patients in hospital beds who did not need to be there.

Councillor Ginn proposed that the workshop focused on the area suggested in the report: Out of Hospital, Joint Commissioning, CLCH, Mental Health, Nursing Homes and Children. Mrs Redmond commented that the CLCH was about a  service, not outcomes.  

RESOLVED THAT:

(i)                  The report be noted.

(ii)        Update reports be considered at the workshop and at the next meeting.