Update from Barbara Hakin

Welcome to this month’s GP and Practice Team Bulletin. This month I want to focus on the forthcoming changes to the commissioning of primary care services, which will happen from April 2013.

The new system will be introduced over the coming months leading up to April and it is important that practices are aware of what is coming and where they can go for help and information.

The new commissioning system

From April 2013, the NHS Commissioning Board (NHS CB) will be commissioning most of the primary care services previously commissioned by PCTs.

The NHS CB will have an overarching role to ensure that the NHS delivers better outcomes for patients within its available resources and upholds and promotes the NHS Constitution. As a single national organisation, the Board will be responsible for ensuring that services are commissioned efficiently in ways that support consistently high standards of quality. At the same time, it will want to ensure that decisions about services are made as locally as possible and involve patients and the public.

Primary care has a pivotal role to play in helping the overall health and care system further improve health outcomes and reduce inequalities. The NHS CB will want to develop an environment in which primary care can build on the very best practice and deliver continuous improvements in quality and outcomes for patients.

At a national level, the NHS CB will work with a range of stakeholders to identify how primary care can best contribute to better health outcomes and the main characteristics of high quality services.  This will take into account national priorities for improving NHS outcomes, evidence from patient experience and insight, evidence from local experience, and innovative practice. The NHS CB will use this to inform the local commissioning relationship between primary care providers and its local area teams and as a basis for developing national contracts.

The Board will want to support and empower GP practices, working through their clinical commissioning groups, to come together to identify the best ways of improving quality and introducing innovative practice. This does not, however, mean that CCGs will play any role in contract management or matters relating to individual clinical performance (e.g. Performers List issues) – these will be managed by the NHS CB.

‘Single operating model’ for primary care commissioning

Following close working with primary care, in June 2012, the NHS CB published a document that provides the detail of the ‘single operating model’ for primary care commissioning.

Direct commissioning of primary care services will be undertaken by local representatives of NHS CB in partnership with local communities – including service providers, local authorities, patients and the public.  These teams will form strong local relationships, working within the context of Health and Wellbeing Strategies, to ensure that commissioning decisions reflect local needs and circumstances.

For more detail on the single operating model for primary care commissioning see this factsheet

Clinical leadership and the role of CCGs

CCGs will have a very important role in providing the clinical leadership needed to help deliver high quality, responsive and safe services for patients. This is likely to include:

• working across practices to understand and compare markers of quality and how they contribute to health outcomes;

• sharing data and information to support improvements in quality;

• peer review, clinical audit and other action to promote quality improvement and understand development priorities across member practices;

• engaging patients and the public

• working collaboratively with the NHSCB to address variability and service improvements.

Next steps

In the coming months, the NHS CB will provide more details about these arrangements including:

• the role of the responsible officer;

• common operating procedures, including performance management;

• GP premises arrangements;

• GP IT arrangements; and

• transitional arrangements for payment and other associated services.

The focus will be on ensuring stability during transition to the new arrangements, establishing partnership arrangements with CCGs, and preparing for the challenges of rising demand/need, especially in the management of long term conditions.

PCTs and local representatives of NHS CB should already be working with practices to provide information and support on the transition to these new arrangements. If you have any questions, or need further information or help and support, please contact your PCT or local NHS CB representative.

Finally can I highlight the publication of the first Mandate to the NHS CB from the Department of Health – see the top story below. The Mandate is the means of providing the long term direction for the NHS and it sets a number of key objectives for the NHS.

These objectives include working with CCGs, GP practices and others to improve information for patients and give people greater control over their health including making sure, by 2015, all patients have access to online services for booking GP appointments, requesting repeat prescriptions and talking to practices, together with online access to their GP records.  The NHS CB will obviously need to work very closely with primary care to identify how best to deliver these benefits for patients.

Dame Barbara Hakin

National Director: Commissioning Development

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2 Responses to Update from Barbara Hakin


    I do hope practices will not be allowed to insist all patients use the online services as a blanket rule will adversely affect many elderly and disabled patients. There must be flexibility willingly given according to patient need.

  2. LYNNE HEAL says:

    Clinical leadership is needed in the UK with MS and CCSVI we are way behind on and look so uneducated on this its embarrassing

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