Strategic commissioning is about planning and delivering services and support for people. It includes identifying the needs of individuals and communities, enabling people to decide what will best address those needs and working together with agencies to put the right services and support in place. Joint Strategic Commissioning – A Definition – June 2012
The Public Bodies (Joint Working) Scotland Act 2014 has highlighted the importance of joint strategic commissioning (referred to there as strategic planning) to achieve the right outcomes for people. The Act requires the NHS, local authorities, and other key partners – including people and carers to work together to produce a strategic plan for adults by April 2016.
The material gathered here offers initial guidance in relation to the development of effective strategic commissioning by Partnerships. They deal with the need for, approaches to, and effects of strategic commissioning, with examples drawn from a range of services.
Joint Strategic Commissioning Learning Development Framework
The idea of strategic commissioning is not new, nor does it relate specifically to any one group or location. In 2012 JIT produced a development framework which explores the skills needed to deliver effective joint strategic commissioning of older people’s services. The framework prompts consideration of the skills, roles and culture needed for effective strategic commissioning. In particular, the material on skills analysis remains relevant.
Understanding commissioning: A practical guide for the culture and sport sector
This sport based view of strategic commissioning shares many similarities with the approaches recommended for health and social care. The guide is accessible, and raises interesting questions about the incorporation of sport and culture into the activities of Partnerships.
Transforming the Delivery of Health and Social Care
The Kings Fund investigated the key determinants of the need for change, and evaluates these in relation to the current and future structure of the health and care system. The paper reflects the condition of the English health and care system in 2012, but provides a useful example of overarching analysis of need that might be used to drive change elsewhere. The later part of the review considers the management of fundamental change within NHS and provider organisations.
In addressing the challenges of efficiency and value for money, the Health Foundation identified four research projects to explore original ideas on system efficiency and value for money. These cover the effects of technology on delivery of care, analysis of the effectiveness of resource allocation, evaluation of good commissioning practice on long term outcomes, and research into the factors which influence the uptake of new approaches.
Management of increasing expectations is dealt with in The Art of Exit, which considers the creative aspects of service decommissioning. Given the limitations on resources, including time and people as well as money, that all services face, this paper presents a considered view of the advantages of decommissioning, that is stopping the services that do not contribute to long term outcomes.
Saving money by doing the right thing
This paper deals with shifting the pressures of increasing demand to more local solutions, and resolution of issues at first point of contact thereby avoiding cycles of ‘failure demand’ which result in increasing pressure on service capacity. The paper draws heavily on the Vanguard method to consider the implications of managing value in services that are defined locally including the example of the Buurtzorg approach to care.
The paper explores evidence from English PCTs in relation to priority setting tools, their merits and the barriers faced in deploying them. It explores the policy, governance, and technical challenges of establishing effective prioritisation, recommending a partnership approach, which incorporates shared decision making. Although the focus is on clinical services, the paper provides an extensive discussion on the implications for future strategic commissioning challenges.