The Intelligent Board 2011 focuses on Clinical Commissioning. The expert reference group believes these new commissioners should “Be bold”, and suggest they, “Don’t start from a position of commissioning more of the same.” The report, sponsored by Dr Foster Intelligence, promotes intelligent clinical commissioning and the intelligent use of information in practice to board members of clinical commissioning groups.
The report was launched at a breakfast meeting at the Commonwealth Club on the 14 September 2011 by the Rt. Hon. Stephen Dorrell MP, Chair of the House of Commons Health Select Committee and Professor David Colin-Thomé, Chair of the reference group and former National Director for Primary Care at the Department of Health.
Professor David Colin-Thomé, Chair of the Intelligent Board reference group said: “NHS commissioning has achieved less than it should have due to a lack of clinical involvement and a dearth of high quality information. We should not be distracted by the fact that some aspects of the new commissioning structures and processes remain to be finalised. Commissioners need to get on and deliver results.”
The Intelligent Board paper summarises the characteristics of the best clinical commissioning:
1. Focusing on patients and populations.
The best commissioners will take responsibility for using their commissioning budgets to improve the quality of both primary and secondary healthcare, to the benefit of the whole local population.
2. Paying for outcomes.
This represents a radical shift in the nature of commissioners’ relationship with providers who will no longer be guaranteed a certain volume of work. Instead, commissioners will require that providers demonstrate how they will deliver a particular set of outcomes for patients. This signals a move away from contracting for discrete services towards commissioning pathways and packages of care.
3. Creating pathways and care packages.
Too much commissioning is currently based on an approach that takes the complex healthcare system and breaks it down into a series of standalone services. This results in multiple contracts with multiple providers and an unhelpful tendency towards micro-management. The result should be a new approach to contracting, most likely involving fewer contracts that specify high-level outcomes rather than detailed processes and outputs.
4. Collaborating and engaging.
The best commissioners will recognise a range of key people as experts who can be enlisted to support effective commissioning, including building new kinds of relationships with patients and local communities and establishing themselves as the ‘people’s organisation’.
5. Being transparent.
Commissioners should be open about their decision-making processes. They should publish information, in jargon-free language, about the policies, principles and information that guide their decisions. They should explain who takes the decisions and how, be open about how conflicts of interest are dealt with, and let local people know how they can contribute to the debate.
Getting the right information at the right time to assist effective decision-making is one important task. Using that information well is another. This document is for clinicians or anyone else interested in taking a role in the leadership of a clinical commissioning group.