Government rhetoric about patient-centred.commissioning is loud and clear. But how will it work on the ground?

Government rhetoric about patient-centred.commissioning is loud and clear. But how will it work on the ground?

The Commissioning Framework for Health and Well-being identifies eight key steps:

1. Putting people at the centre of commissioning

This involves giving people greater choice and control over services and treatments, including self care. It also means access to good information and advice to support choice. Mechanisms will be developed to help the public get involved in shaping these services, with advocacy for support groups who find it hard to express their.views.

2. Understanding the needs of populations and individuals

Joint strategic assessment by councils, PCTs and practice-based commissioners will help them better understand the needs of individuals. They will be able to use assessment and care planning processes appropriately, and mitigate risks to the health and well-being of individuals.

3. Sharing and using information more effectively

In order to make good decisions for individuals and groups, we need to use and share information in an effective way. This includes clarifying what can be shared under what circumstances, joining up the IT systems of front-line practitioners, and encouraging individuals and communities to be co-producers of information.

4. Assuring high-quality providers for all services

Commissioners should develop effective, strong partnerships with providers and engage them in needs assessments. Procurement should be transparent and fair. Commissioning will be focused on outcomes, leading to more innovative provision, tailored to the needs of individuals and supplied by a wider range of providers.

5. Recognising the interdependence between work, health and well-being

Commissioners can facilitate collaborative approaches with businesses to improve advice and support for individuals. Also, all providers of NHS care will be incentivised to support and promote the health and well-being of their employees.

6. Developing incentives for commissioning for health and well-being

Bringing together local partners using local area agreements will help to promote health, well-being and independence. Contracts, pooling budgets and using the flexibilities of direct payments and practice-based commissioning are among the key mechanisms.

7. Making it happen - local accountability

The Department of Health and the Department for Communities and Local Government will develop a single health and social care vision and outcomes framework, including a set of outcomes metrics aligned with the framework.

8. Making it happen - capability and leadership

The DoH and other national stakeholders will provide support to all local commissioners to address their capability gaps. This support will be tailored to different types of commissioners - PCTs, practice based-commissioners and local authorities.

Together, the eight steps build up an ideal of what patient-centred care really mean. When all the disparate elements are working together, excellent examples of genuine.joined-up working can result, as the following case studies show.

Ali's story - how carers can take control

'My daughter, Ali, is 16 years old and has complex and continuing health needs. Eighteen months ago, we were anticipating a crisis - Ali's foster mother was planning to retire, the respite services offered by the local authority were unsuitable, and the local children's department was struggling to find any alternatives.

'The final solution involved us taking control by means of an 'individual budget', which we use to hire our own wrap-around staff team for Ali. The beauty of an individual budget has meant that we can hand-pick personal assistants to ensure we get the right people for the job, people we can trust and feel comfortable around. Ali enjoys having these new friends in her life to help her become more independent. Her social life has taken on a new dimension.'

Click here to read more.about individual budgets

Eric's story - pedaling back to health

'I am 65 years old, and live in Cornwall. Last year, I was waiting for a hip replacement when my health visitor referred me to Pedal Back the Years. I began to go on cycle rides in beautiful scenery regularly, and made some good friends. The exercise and companionship offered by PBTY was invaluable.

'I've now had my hip replacement and am back on my bike! PBTY not only gives me a reason to take regular exercise, but provides support with up-to-date advice. It is also an added boost to my cardio vascular exercise routine, which I have been on since having a heart attack some years ago. Some younger people I have met on the scheme have been able to go back to work, because they are fitter, and have so much more confidence.'

Read more about Pedal Back the Years