The eight Clinical Commissioning Groups in Lancashire and South Cumbria are working in partnership to deliver more integrated care for local people. This work aims to create a focus for the health and care system to work very differently, agreeing plans to improve the whole population’s health, using partnerships to improve the quality of health services and bringing the system back into financial balance.
Commissioning leaders have a clear intention of building on the best work undertaken with our partners to improve health and join up health and care services and community assets in neighbourhoods, five local health and care partnerships (Central Lancashire, Fylde Coast, Morecambe Bay, Pennine Lancashire and West Lancashire) and across the whole of Lancashire and South Cumbria. A period of formal engagement is underway with local member practices, CCG staff and other stakeholders including providers, local authorities, Healthwatch and patient/public groups to consider options for changes to NHS commissioning in Lancashire and South Cumbria.
Following the engagement process, and taking account of any feedback received, it is clear that any decisions regarding reforming Clinical Commissioning Groups can only be made by the member GP practices. Our plan at this stage would be to hold such a vote in each CCG in May 2020. It is envisaged that any application would be submitted to NHS England in September 2020, with the potential for a single CCG for Lancashire and South Cumbria being fully established on 1 April 2021.
A case for change document is available and is the basis for local discussions. This is a technical NHS document intended to begin an engagement process with GP members, partner organisations and other stakeholders of the eight CCGs in Lancashire and South Cumbria.
The new commissioning system story so far
August 2018 marked a one-year milestone in Lancashire and South Cumbria’s journey towards a new commissioning system. Key to our experience is the importance of putting the right people alongside the best processes and using the most honest approach to make improvements in a complex area.
You can access an article which describes that journey, focusing on the lessons learnt in the ﬁrst year of what will ultimately be a long-term plan for change. We talk about the importance of ‘buy in’ and co-production as well as the need for clear project design and the incorporation of bespoke ways to make decisions based on data and evidence as well as passion and governance.
What is commissioning?
NHS England describe commissioning as:
Commissioning is the continual process of planning, agreeing and monitoring services. Commissioning is not one action but many, ranging from the health-needs assessment for a population, through the clinically based design of patient pathways, to service specification and contract negotiation or procurement, with continuous quality assessment.
There is no single geography across which all services should be commissioned: some local services can be designed and secured for a population of a few thousand, while for rare disorders, services need to be considered and secured nationally.
Who commissions services?
Across Lancashire and South Cumbria most services are commissioned by Clinical Commissioning Groups (CCGs), however some services are determined by NHS England and these are same across the country.
Reviewing commissioning policies
As part of our development work in this area we are trying to ensure fair access to services for everyone who lives in Lancashire and South Cumbria. To do this we are reviewing clinical policies to make sure each CCG offers the same access and levels of treatment, this will end what has been called 'the postcode lottery'. This process is called commissioning policy development.