Written evidence from Health Care Professionals
Commissioning Network (COM 132)
MULTI PROFESSIONAL
INVOLVEMENT IN
COMMISSIONING—10 HIGH
IMPACT ACTIONS
Background
The Health Care Professionals Commissioning
Network, hosted by NHS Networks, works alongside the National
Clinical Commissioning Network to broaden professional influence
in GP commissioning.
The network brings together local and national
clinical leaders from nursing, pharmacy, dentistry, optometry
and the allied health professions to discuss, debate and recommend
how GP commissioning needs to develop and benefit from the insights
and experience of a wide range of health care professionals working
in union with GPs.
This paper is presented in response to the question:
"How can multi-professional involvement
in commissioning most effectively be promoted and sustained?"
It aims to help politicians, policy makers and
emerging GP commissioning consortia think about how they can engage
a wide range of health professionals in GP commissioning so that
from now on, despite challenging financial times, transition and
massive organisational upheaval across the NHS, commissioners
base their decisions on the collective wisdom of all those who
care for local communities.
We believe that service users and carers need
to be fully involved in commissioning. They are the ones best
placed to see the flaws in the current system and realise the
opportunities of the new.
We see GP commissioners needing to develop innovative
ways of delivering patient and public involvement in commissioning
so that they can look at the world through the eyes of service
users.
For similar reasons, we believe that GP consortia
that engage with and gather insights from a wide network of health
care professionals will paint a richer picture and have a deeper
understanding of the difference NHS services in the round make
to people's lives.
We commend the Health Select Committee's recognition
of the value of ensuring multi professional involvement in commissioning.
We have focussed our current thinking into 10 immediate high impact
actions that we believe will drive this. We hope they inform your
thinking.
TEN HIGH
IMPACT ACTIONS
1. Create the right culture.
Create an open, collaborative culture now. Given
health care is a complex jigsaw, acknowledge that there are things
GP commissioners may not know or don't know but need to know in
order to make good commissioning decisions.
2. Have an open door policy.
Welcome and actively encourage approaches from
health care professionals who want to engage with the development
of GP commissioning.
3. Involve people from the start.
People tend to support best that which they
help to create. When people have an input from the beginning,
everyone benefits from the collective insight and information—and
it creates shared ownership of decisions.
4. Understand how your community really uses
health services.
Investigate which health and social care professionals
(other than GPs) have regular contact with and from whom people
get support. This is an important part of a needs assessment.
Use this information to inform commissioning. Build on these interactions
and relationships. They are a valuable and underused asset.
5. Expect everyone to deliver the right care.
Set ambitious and explicit expectations that
everyone across the system needs to focus on delivering "the
right care" (right place, right people, right intervention,
right outcomes). Promote and nurture innovation amongst providers,
including new approaches to skill mix.
6. Build local multi professional relationships.
Prioritise the development of local multidisciplinary
networks (across providers and commissioners) to engage a wide
range of health care professionals and providers in service redesign,
commissioning and provision of services.
7. Encourage multidisciplinary clinical leadership.
Work with clinical leaders across the health
professions to drive transformational change, quality improvement
and challenging peer review.
8. Copy, improve and pass on good practice.
Most things have been done already somewhere
else; often led by other health care professionals. If it works
there, it will work locally too. Plagiarism of success should
be embraced and extended—and it saves time and money.
9. Encourage and enable shared CPD.
People who learn together work well together.
Take a lead role and responsibility for increasing understanding
amongst all local health care professionals about what GP commissioning
entails and how everyone has a part to play in making it a success.
10. Consider sharing budgets.
Where health care professionals eg optometrists
or dentists refer directly or indirectly (via general practice)
to secondary care, consider how to share responsibility for budgets.
Develop agreements for direct referral to reduce transaction costs.
Give them the freedom to test innovative approaches that minimise
referrals in order to keep care in the community.
November 2010
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