Written evidence from Astellas Pharma
Ltd (COM 117)
CLINICAL ENGAGEMENT
IN COMMISSIONING
1. We believe that there are three key areas
which will assist GP consortia to make good commissioning decisions:
1.1 Access to information and data—the
collection of meaningful data about the performance of primary
care providers will enable consortia to identify where problems
need to be addressed and where examples of good practice are being
exhibited. Only by having this information will consortia be able
to build a picture of the quality of constituent practices, and
take appropriate steps to improve on this.
1.2 Ongoing professional education and training—consortia
should be responsible, in part, for ensuring that appropriate
ongoing professional education and training is made available
to practitioners working for their constituent members. This is
particularly important in conditions relating to LUTS, where there
is evidence that training is inconsistent.
1.3 Peer review—peer review should
be extended into primary care so that teams and individuals are
benchmarked against their peers, so that development needs can
be identified and addressed. This approach may also help to foster
a collaborative relationship between GP practices, encouraging
professional learning and the spread of best practice.
ACCOUNTABILITY FOR
COMMISSIONING DECISIONS
2. Patients should be involved in the planning
and evaluation of services. Therefore, consortia and the Commissioning
Board must engage with both local and national HealthWatch. Commissioners
would also benefit from direct engagement with patients who have
personal experience of a particular medical condition, such as
LUTS, to seek their insight into how services can best be organised.
3. The development of quality accounts in
secondary care is beginning to give an insight into the performance
of providers and allows patients to make comparisons about the
services they wish to access.[183]
We believe quality accounts should be introduced within primary
care as quickly as possible, as they would also provide scrutiny
in relation to commissioning.
4. Similarly, we believe the Quality &
Outcomes Framework (QOF) can be used to improve the quality of
primary care and it can provide a useful benchmark for commissioning
bodies.
5. However, the QOF does not currently provide
an incentive to identify and treat patients with LUTS. Therefore,
the following three indicators should be added to the QOF:
— The percentage of patients with LUTS
with a care plan in place and shared with the patient.
— The percentage of LUTS patients offered
treatment.
— The percentage of people over 65 and
in at risk groups, including people with learning disabilities,
neurological conditions and immobility, who have their continence
status recorded in their patient record in the preceding year.
THE ROLE
OF LOCAL
AUTHORITIES
6. We recognise the increasing role that
local authorities will play in improving the health and well-being
of local communities and their input to the planning of community
based health & social care services. Commissioning consortia
should take an active role in the development of the Joint Strategic
Needs Assessment to determine local priorities and ensure that
there is a joined-up approach to services. LUTS is a significant
problem in social care and one reason why people are no longer
able to live independently.
7. The development of a commissioning outcomes
framework to performance manage commissioners will be an important
way of raising the quality of care and should include outcomes
indicators for the treatment of LUTS that consider the interventions
made by the public health service (eg awareness raising), the
NHS (eg diagnosis and treatment) and the social care service (eg
where the patient is being cared for in a social care setting).
8. Multi-professional involvement in commissioning
is essential, particularly where services, such as those for LUTS,
fall across acute care, medical, surgical, primary, care homes
and community care. Professionals from all of these settings must
be included in the commissioning process to ensure that services
are joined-up across health boundaries.
LEVERS AND
INCENTIVES
9. To make the proposed commissioning structures
work effectively, it will be essential that the NHS Commissioning
Board and GP commissioning consortia work together to monitor
and manage performance in primary care. There are a number of
incentives and levers which already exist which may help to achieve
this, including:
9.1 Data collection and analysis—as outlined
above the systematic collection and analysis of data, can provide
oversight of primary care performance. In particular, for conditions
such as LUTS, it is essential that patient reported outcomes are
captured through appropriate Patient Reported Outcome Measures
(PROMs), as LUTS can significantly reduce sufferers' quality of
life.
9.2 Quality accounts—as outlined above,
the development of quality accounts in secondary care is beginning
to give an insight into the performance of providers and allows
patients to make comparisons about the services they wish to access.[184]
We believe quality accounts should be introduced within primary
care as quickly as possible, as they would also provide scrutiny
in relation to commissioning.
10. In our view it is important that local
commissioners are incentivised for efficient and effective commissioning.
The NHS Commissioning Board should consider a mechanism similar
to the QOF to ensure that good commissioning is rewarded and to
encourage poorer commissioners to improve. This type of incentive
would also facilitate the collection of performance information
about commissioning, thereby allowing best practice to be identified
and spread.
ABOUT ASTELLAS
Astellas is an R&D driven global pharmaceutical
company that develops and markets effective therapies for diseases
where there is an unmet clinical need such as the treatment of
lower urinary tract symptoms (LUTS), including overactive bladder.
Our European and UK operation is headquartered in Staines, Middlesex,
and the company has a UK workforce of 250.
October 2010
183 Health Mandate, Accounting for quality: an analysis
of the impact of quality accounts in the NHS, September 2010 Back
184
Health Mandate, Accounting for quality: an analysis of the
impact of quality accounts in the NHS, September 2010 Back
|
