Winner: Tower Hamlets PCT

A detailed, three-year commissioning plan was at the heart of a strategy to tackle health needs in the fourth most deprived borough in the country

The London borough of Tower Hamlets is ranked the fourth most deprived in the country.

The challenges facing Tower Hamlets primary care trust have included a high level of health inequalities, with significant rates of diabetes, cardiovascular disease and cancer. There is also a need to develop the capacity and quality of primary and community care services.

The award-winning strategy, Improving health and well-being, is informed by local health needs assessments to identify priorities across the borough, with key actions determined through multi-agency events and public forums.

The commissioning approach provides a unifying and motivating framework for health and social care professionals to work together and to aspire to ambitious improvements for service users.

Implementation of the strategy has been underpinned by a detailed three-year commissioning plan aligned to the local area agreement. Benefits to date include: a newly commissioned, local enhanced service with extended hours at 34 out of the 36 GP practices in Tower Hamlets; the commissioning of a suite of pharmacy-enhanced services; a flagship LIFT development to bring more services out of hospital and closer to local people on the Isle of Dogs; mobile dental services; and a health hotline, making it simpler for the public to access information about services in the borough.

The judging panel commented on the "superb demonstration of a committed and dynamic partnership across the whole system, tackling health inequalities to transform outcomes for deprived communities".

Improving health and well-being, contact

Highly Commended: East Lancashire PCT

East Lancashire is delivering demonstrable improvements in life expectancy for a disadvantaged population. The project is focused on five areas: cardiovascular disease; alcohol harm reduction; infant mortality; drug services; and geographical inequalities.

The PCT has adopted the world-class commissioning framework of vital signs, competences and governance to deliver its vision to Save a Million Years of Life by 2011.

East Lancashire stresses an understanding of the local health experience down to ward level, mapping existing services and identifying actions to address the causes of ill health. Infrastructure has been strengthened to build capacity and improve health through leadership and partnership.

Save a Million Years of Life, contact

Highly Commended: West Midlands Specialised Commissioning Team

This is an excellent example of collaboration in commissioning across health economies, which delivers meaningful improvements that would be difficult to achieve by an organisation standing alone.

The project has redesigned the care pathway for patients presenting with heart attacks in Dudley, Walsall and Wolverhampton. The condition is diagnosed by the ambulance crew, with patients then transferred to the Heart and Lung Centre in Wolverhampton for emergency primary angioplasty.

In its first year, the pathway was activated 646 times, with 449 patients treated with emergency angioplasty. In-hospital mortality was below 3.5 per cent and bed stay fell from 5.3 to 3.9 days.

Heart attack centre, contact

Finalist: Dudley PCT

Dudley PCT has been working with its local authority partners to develop a joint commissioning strategy that describes the needs and issues affecting the borough's population over the next five years.

This sets out goals to meet these changing needs, along with commissioning intentions, which will be used to make decisions on commissioning priorities.

The prioritisation tool (part of the framework) makes the views of patients and clinicians central to commissioning. The tool, which takes core national priorities along with those determined by the public and clinicians in Dudley, has been used to inform this year's local delivery plan funding and was the first step towards embedding this new commissioning approach.

Commissioning services that truly meet the needs of local people, contact

Finalist: Stockport PCT with Stockport Managed Care Company

Stockport Managed Care, a non-profit-making society with a management of services agreement with Stockport PCT, has 54 GP practices as "members".

It aims to assist practices to ensure world-class healthcare is, wherever possible, provided out of hospital by improving the commissioning of health services and also through clinical and management training.

The society's rules require members to remain within budget for practice-based commissioning, attend relevant training and follow accredited pathways and referral protocols. It is developing service models, detailed protocols and pathways while commissioning quality improvements in the pathways.

Accountability framework, contact