The primary aim of world class commissioning is to improve the skills of primary care trusts to make them more effective commissioners. The 11 WCC competencies focus on the key areas required of PCTs, but some areas are inevitably more developed than others.
One area where commissioners report potential weakness is procurement. This is particularly important with the increasing role of non-NHS providers in the healthcare market, i.e. the independent and third sectors.
Nowhere is this more prominent than in mental health, where increasingly the independent and third sectors are meeting the need for sub-specialist services and other gaps across England.
The role of non-NHS providers in the healthcare market is on the increase. That makes procurement a particularly important competency within world class commissioning, which aims to improve the skills of PCTs and develop more effective commissioning.
The policy drivers in mental health, as for other services, are to provide better outcomes, quality and value as identified in the next stage review, together with New Horizons and recent changes in legislation (the Mental Health Act 2007).
These are set against potential pressures on NHS funding in the light of current economic circumstances, which look set to continue for some time.
Studies have shown that by 2011, better regulation and simplification and improved contracting processes, including the use of the Standard NHS Contract for Mental Health, have the potential for significant cost savings and delivery of better outcomes for service users.
Against this background the NHS Purchasing and Supply Agency, in conjunction with health and social care partners, has developed a mental health roadmap to support commissioners to procure services more effectively.
A clear route to better outcomes
The new online resource is aimed at commissioners of mental health services for people of all ages, including child and adolescent care. It contains practical tools, guidance, case studies, templates and useful links to information from the Department of Health, NICE and other relevant organisations.
Importantly, it integrates the commercial and procurement elements with clinical aspects, to help PCTs obtain the most from the provider market and enable quality, improved service delivery and value for money in driving better outcomes.
The roadmap helps commissioners, both PCTs and local authorities, implement policy and guidance from the Department of Health on world class commissioning and facilitating system management. It does not replace any policy or guidance; rather it brings together the necessary tools and information in a ‘one-stop shop’ to help commissioners through the complexities of commissioning and procurement.
Follow the signs
The mental health roadmap is structured in such a way as to take commissioners through eight key stages (or “road signs”) from the policy background, developing a procurement strategy and market intelligence to contracting for mental health services, with good practice examples along the way.
On each road sign there is a list of the specific world class commissioning competencies that are met, so commissioners can be clear which skills are being addressed.
At each “road sign”, commissioners can download documents and templates for use locally and there are links to relevant websites in support of the area discussed. In addition, there is a section on the latest updates or breaking news, ensuring that commissioners are kept abreast of the most recent policy changes, good practice, legislation, etc.
Users of the roadmap can click onto any of the eight road signs for further information in the relevant area and there are cross links to other road signs to ensure that all essential aspects of the commissioning/procurement process have been covered before embarking on the next stage.
Users can also provide feedback on the usefulness of the roadmap at each “road sign” and suggest various improvements to this resource.
The right tools for the job
At the core of the roadmap is a toolkit to guide commissioners through the procurement process should this option be considered when contracting for mental health services. This toolkit comprises five stages: identifying the need, getting ready to procure services, procurement, transition to safe service and contract management.
The mental health roadmap went live in December 2008 and is currently averaging about 800 hits a month. The resource is under regular review and updated by a steering group of key stakeholders.
For example, a briefing called “recession watch” was recently incorporated, drawing the attention of commissioners to the need to reduce any risks posed by adverse economic situations that could affect the provision of healthcare in their area.
Subjects covered so far include assessing the financial stability of providers and managing increased demand in healthcare caused by a recession
Another area of work is the development of a library for service specifications so that good practice examples can be shared with other commissioners. NHS PASA is working closely with NHS Evidence to develop an accreditation system for service specifications.
Other roadmaps have been published. The roadmap for community services went live in June; acute and ambulance services went live in July.
The roadmaps are available at http://www.pasa.nhs.uk/PASAWeb/PCTzone/Yourroadmap/
Dr Hugh Griffiths is deputy national clinical director, Mental Health, Department of Health, and Dr Thoreya Swage is clinical adviser, NHS Purchasing and Supply Agency.