World class commissioning is not a status to be achieved and retained but an ongoing process of improvement which has patients’ changing needs at its heart

Last week, on 16 September, I launched the second year of the world class commissioning assurance process - the system we introduced last year to drive performance and development, and reward primary care trusts as they move towards becoming truly world class commissioners.

I realise PCTs will need support to deliver against the objectives and we have put significant effort into providing resources

Our first year was a rigorous and challenging but fair process, which has provided valuable lessons. It was co-produced with PCTs and strategic health authorities and has already started real behaviour change, which will deliver long term health improvements for patients. I see regular evidence of this on my many visits to PCTs.

Commissioning has never been more important given the need for greater efficiency the NHS faces. World class commissioning has always been about improving health outcomes and reducing inequalities through better quality, increasing productivity and having a long term focus on prevention. It is essential that PCTs, as the local leaders of the NHS, now act as the agents of transformation that sets the health services on the path for the future.

Working better will produce natural efficiencies. The world class programme involves developing better ways to do things, delivering better quality for patients. Quality does not have to be expensive. This is not just about cutting costs, it is about increasing productivity and being efficient, and the very best commissioning will do that.

Last year, I was pleased to see so many PCTs rose to the challenge in selecting their local health outcomes and that there was much consensus on the real priorities (the same 10 outcomes were chosen in 60 per cent of PCTs), and that these were based on real evidence of need and backed up by quality data.

We all recognise that some of the health outcomes present significant challenges. Reducing obesity, persuading people to quit smoking or not to start at all, or reducing the number of expensive alcohol related hospital admissions will not be easy. Just as importantly, promoting the prevention and earlier identification of potentially debilitating or life threatening diseases could provide patients with access to treatments more quickly, creating better outcomes and quality of life and avoiding more expensive interventions.

Encouraging and supporting great clinical leadership will be a cornerstone in delivering better outcomes. PCT boards must ensure clinical leaders are being supported in driving change, not just in their own organisation but also across boundaries into secondary care, social care, the voluntary sector and across health communities.

So PCTs will need to continue to take a big picture approach to the future health challenges of the local population: addressing long term needs, prevention and early treatment and working together with crucial partners to shape the right services and then invest to make it happen.

Patients first

Keeping the needs of the patient at the heart of everything we do will provide real insight into how best to deliver the services that meet the needs of the community, improving health outcomes, reducing inequalities and strengthening the prevention drive. “World class” will not be a status that is achieved and retained through a rating process alone. In order for the NHS to continue to meet the population’s changing needs, it will be a process of ongoing improvement. PCTs will need to constantly refine and improve, engaging with patients and clinicians to ensure integrated services are commissioned, which “make sense” to patients and improve quality and care.

Our timetable means most PCTs have until mid January to prepare for a streamlined assurance process. We know this period will be challenging, with other health priorities such as swine flu requiring resources, but PCTs must push ahead and use world class commissioning as an enabler to help them through difficult times. To that end, I hope that PCTs see world class commissioning as a way of working rather than an add-on.

I realise PCTs will need support to deliver against the objectives and we have put significant effort into providing resources, including everything from the framework for procuring external support for commissioners guide to workshops for PCTs to support them through the assurance process. We will continue to make our publications as simple, up to date and user friendly as possible. I would also encourage you to sign up to our world class commissioning networks site.

World class commissioning is now more important than ever, and the start of year two is an opportunity to look forward to what PCTs working with partners, clinicians and the local population can achieve.