Supporting CCGs during the NHS restructure
The emergence of the new commissioning consortia signalled a major change for the NHS. Sustain delivered a range of projects to support the new organisations as they developed their skills and capability.
Out of hospital care and admission avoidance:
We were commissioned to review a “one stop” system which gave elderly or infirm patients fast access to assessment and appropriate support within the community, in turn helping to reduce A&E attendances and unnecessary hospital admissions. Although the service had been successful when it was first introduced, various changes within the local environment had seen its availability reduce and impact diminish.
Keen to gain a better understanding of the key actions which would be needed to reinstate the service at its original level, the local consortia asked Sustain to carry out a full scale review.
We provided an extensive document, which defined:
Ensuring a fair share
- the key features which were at the core of the original service and essential to its success
- its mode of operation and service level expectation
- its communication and publicity needs
- the key areas of engagement which would be required
- learning from the original model which could be used to improve the newly launched service
We were brought in after an emerging GP consortium received statements showing a major adverse comparison of their indicative budgets against the fair share. The information came at a time when the consortium was deciding its spending priorities and showed that major divestment would be needed to bring planned spending in line with the consortium’s allocation.
We were asked to examine the statements and make enquiries with the primary care trust about the assumptions which had been used to calculate the figures. Using our knowledge of the area’s history, we were able focus our enquiries and provide some educated estimates for a more appropriate funding level.
Through our investigations, we discovered the assumptions made in calculating the allocation were based on contracts which had since been superseded. The figures were later reissued, ensuring the consortia received a fairer share.
Facing the challenge of the NHS reforms:
Following the publication of the Government’s white paper detailing the proposed NHS reforms and the expectations which would be placed on the new GP commissioning consortia, Sustain was asked to produce a discussion document looking at some of the key issues facing a local consortium.
The extensive report identified:
- the critical milestones within the proposed legislation
- the expectations of the local primary care trust
- our views on overcoming the major challenges which would face the consortium
- key risks and possible mitigations
- the processes which would be necessary to drive an overarching organisational development programme
In addition, we used our experience of the World Class Commissioning process to predict the areas, processes and headlines which would be included within any authorisation process.