Am I competent? We must all have asked ourselves this question. In the build-up to world class commissioning assessment, it is interesting to ponder what competency we have and whether we have any weak links.
I am sure some younger readers are asking: is there a future in becoming a commissioning guru? Should we be generalist or specialist? Perhaps the best known generalists are trust chief executives. Whether they have come through the management training scheme or through finance or clinical leadership routes, they have usually developed a broad knowledge of the business, often with experience in commissioning and providing roles.
There are many strengths in being a generalist. I promote the concept of everyone having a core knowledge in all 11 competency areas of world class commissioning. The 11 areas listed below are also designed to ensure that through the commissioning process primary care trusts are recognised as the local leaders of the NHS:
locally lead the NHS;
work with community partners;
engage with public and patients;
collaborate with clinicians;
manage knowledge and assess needs;
stimulate the market;
promote improvement and innovation;
secure procurement skills;
manage the local health system;
make sound financial investments.
You will notice that this list of competencies cuts across traditional roles. Think about each of the 11 as chambers of knowledge: you may not need to be an expert in all 11 areas but you should have at least some knowledge in every domain.
Different members of the commissioning team might specialise in three or four domains: expert or super-specialist in certain areas. But the most important idea would be to have at least a basic knowledge of all 11 areas.
This would form the basis of an expert commissioning team with capability and capacity to form the commissioning organisations the world class commissioning process is aiming to develop.
It also means that commissioners of the future will find it easier to transfer skills from one competency to another. This could create more opportunities for learning new skills and taking on a variety of posts in the commissioning structure. Accountants should have opportunities to develop skills in creating clinical leadership or developing care pathways, in the same way as directors of public health or nursing should be able to lead procurement exercising or manage business cases.
Experts will still be needed and I assume the NHS will still want directors of finance or public health for the expertise they can bring but the complexity of commissioning means we need an increase in our general knowledge of the NHS business.
Most commissioners may become more like mini chief executives (more generalists than specialists) and there is nothing wrong with that, is there?