Pathfinder bulletin – September 2011

In this month’s issue:

Welcome from Barbara Hakin

Dame Barbara HakinWelcome to the September 2011 issue of the Pathfinder bulletin and, as we move into autumn, the pace of work continues both here and across the country.

This month’s bulletin includes news on a number of key announcements, including the publication of the latest version of the authorisation framework and the release of the ‘ready reckoner’ running costs tool for clinical commissioning groups. There is also an update on the development of clinical networks and clinical senates.

Thanks to all the feedback we received from our pathfinders, NHS colleagues and stakeholders, our thinking around authorisation has moved on since we shared the first version of the framework with you in August. Today we published the latest version of Developing clinical commissioning groups: Towards authorisation which responds to many of the comments we received, and there’s more information about that below. We do recognise that there is still further thinking to do around a number of areas and we would still be interested in hearing your views. We expect the shadow NHS Commissioning Board to publish another update in spring 2012 following further engagement.

With the release of the ‘Ready Reckoner’ we hope to stimulate local discussions between emerging CCGs and PCT clusters about commissioning support options. It is clear that the development of high quality commissioning support will be one of the key challenges we face over the coming months, and I know there is a lot of work going on across SHAs to gather views and understand the current situation. It’s critical to establish commissioning support functions that can deliver highly effective support but at a reduced cost, so to support this we plan to publish guidance on the next steps for commissioning support very shortly.

In the meantime, we will be looking to you as pathhfinders to work closely with your PCT clusters and colleagues to consider options for ensuring that you can access high quality, responsive commissioning support. As you know, I believe passionately that excellent support is vital if we are to enable you as clinical commissioners to carry out your roles effectively and deliver the best outcomes for patients.

As always I would be very interested to hear your experiences of this journey, whether you have successes to share or learning to help others. Equally, if you have views or comments on any of the topics featured in the bulletin this month, please do feel free to let me know. You can send your comments or questions to I look forward to hearing from you.

Kinds regards
Dame Barbara Hakin, National Managing Director of Commissioning Development

Towards authorisation

Today we published the latest version of Developing clinical commissioning groups: Towards authorisation. The document sets out current thinking to help emerging clinical commissioning groups (CCGs) consider the steps towards authorisation. It describes the processes that may need to be in place to ensure that CCGs are highly effective, with the leadership and confidence to discharge their healthcare and financial responsibilities.

As part of the publication process, we shared an early draft of the document in August and invited comments from pathfinders, NHS colleagues and other key stakeholders. Thank you for the constructive, reflective and perceptive comments we received. We have reflected some of these comments in this version, in particular:

  • the technical annex on the configuration risk assessment
  • the section on the road map to authorisation
  • development areas for CCGs
  • references to patient and public engagement
  • adding an executive summary
  • updating technical annex 3 to reflect many of the comments received.

We have also updated the document where the position has developed in the last few weeks, for example technical annex 1 (legislation).

To accompany this document, answers to some of the questions / points that were frequently raised in response to the August draft have been published here on the Pathfinder Learning Network. However, many of the comments highlighted a range of issues where further thinking is required and will be taken forward in developing the forthcoming governance framework and the next level of detail on authorisation.

Our intention is that the shadow NHS Commissioning Board will publish another update of the framework in spring 2012 following further engagement with emerging clinical commissioning groups and stakeholders.

‘Ready Reckoner’ running costs tool for clinical commissioning groups

Earlier this month the Secretary of State announced the release of the ‘Ready Reckoner’, an interactive tool for clinical commissioning groups (CCGs) to map their potential running costs based on various commissioning support options.

Developed in partnership with pathfinder groups, Strategic Health Authorities (SHAs) and PCT clusters. the tool will help CCGs understand the financial implications of different commissioning support arrangements and delivery models. It will also give CCGs the flexibility to work through the potential impact that their population size has on resources and staffing structures.

The Department hopes that by making this tool available it will help stimulate a range of local discussions between clinical commissioning groups, and with PCT clusters and SHAs, around opportunities for CCGs to collaborate with others, share functions or become part of a larger federation to benefit patients. Most importantly,  it allows CCGs to consider how they can use external support options that are cost effective and leave the maximum resources available for clinical and quality design.

See further information and download a copy of the running costs tool here.

Developing clinical senates and clinical networks

The role of clinical networks and the new clinical senates is being developed in a review led by Dr Kathy McLean who chaired the Future Forum workstream on clinical advice and leadership. The work is expected to lead to a suggested operating model for clinical networks and proposals for the operation of clinical senates.

The review will define the role of clinical networks and consider their range, function and effectiveness. Dr McLean, who is Medical Director of NHS Midlands, has established a small project group to oversee the development of proposals, working with network leads and co-ordinators to gather baseline information.

Clinical senates are expected to bring together clinical leaders across broad areas of the country to give clinical leadership and expert advice for commissioning. The development of draft proposals is being overseen by a core project group, working to co-produce suggestions with a wider group including national clinical directors, GPs, policy leads, commissioners, academics, network teams, voluntary sector, patient groups and Royal Colleges.

“I am keen to engage as widely as possible to develop proposals for the operation of clinical senates,” said Dr McLean. “The listening exercise made clear how important clinical advice and leadership are in delivering improvement in health outcomes in the coming years – clinical senates and clinical networks will be a key part of that.”

Read the letter from Dr Kathy McLean and details of how to get involved.

Tackling health inequalities and promoting equality: rapid update sessions on 3 and 8 November

In response to feedback from a number of pathfinders, two rapid update sessions have been organised to offer additional support around tackling health inequalities and promoting equality in the new commissioning world.

The sessions are running in London on 3 November 2011 and Leeds on 8 November 2011. Each session will support pathfinders in:

  • sharing good practice and learning
  • finding out what the law will require of clinical commissioning groups (subject to legislation)
  • building your track record
  • accessing further information and development opportunities.

You have until 7 October to book your place. To find out more please visit the Pathfinder Learning Network.

Three pathfinders chosen for learning disability project

Three pathfinder clinical commissioning groups (CCGs) have been chosen to work with the Department of Health and the Learning Disabilities Observatory on a project to look at commissioning services for people with learning disabilities.

The project has been set up to support CCGs as they begin to commission community, hospital and more specialist health services for people with learning disabilities. It will build on recent work to improve the care and provision for people with learning disabilities and enable the groups to share the learning with the wider clinical commissioning community. The three CCGs are:

  • A partnership between Cambridgeshire and Peterborough
  • Gloucestershire
  • Nene Commissioning

Find our more on the Pathfinder Learning Network.

Gateway reference: 16690

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