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Commissioning in the NHS

Information needs of commissioners
Anne Gray,
Knowledge Officer, Milton Keynes CCG
Commissioning Handbook for Librarians workshop May 2013
Local HealthWatch

CCGs
NHS E
ATs

LAs

Structure of the NHS
Clinical Research
Networks
Relationship between organisations
Advice and performance management
Relationship between organisations
Regulating and monitoring the quality of services
Clinical Commissioning Groups
• Consortia of general practices with responsibility for
commissioning local health services across England.
• Commissioning responsibilities include:
– planning services, based on assessing the needs of the
local population;
• planned and emergency hospital care,
• rehabilitation,
• most community services and mental health and learning disability
services.

– securing services that meet those needs
– monitoring the quality of care provided.
Business needs
• CCGs are businesses whose members are
themselves small businesses
– Requirements from authorisation eg financial
management, leadership, capacity, sustainability,
innovation
– Activity in General Practice (eg referrals) is central
to managing activity but GP (primary care)
contracts are managed by NHS England NOT CCGs
Information needs assessments
1.
2.

NHS Staff survey tfpl 2005
NHS Networks survey to support development of
Commissioning Zone 2010
3. The Intelligent Practice: Understanding the
information needs of GP commissioners (Dr Foster
2007)
4. Commissioning Intelligence model -government
engagement exercise 2011
And finally • Information needs around commissioning –
presentation by Dr Andrew Jones, BMJ
1. NLH NHS Staff user survey (tfpl 2005)
Re: service development in primary care
Managers want information
about
• government policy and
guidance
• regulations
• news
• statistics and demographics
• clinical/scientific/and
technical information,
• information about projects
being undertaken by other
trusts.

Format
• Summarised information
and structured enabling
readers to move quickly
from high level information
to detail.
Alerting services
• Highly valued
• Important to minimise the
risk of missing critical
information both for NHS
and external information.
2. NHS Networks survey 2010
• Support development of Commissioning Zone
– 87 GPs, 133 PCT, 42 others

• Most useful types of information
1.
2.
3.
4.
5.
6.
7.
8.

Case studies
Templates/business studies
Practical guides
Official expert guidance
Analytical tools
Legislation
Frameworks
Research

• Both push (eg email) and pull content important (eg online)
NHS Networks contd/
- User wish list
•
•
•
•
•

A single source of information
Powerful search tools
Email alerts
Access to reliable up to date source data
A range of templates, frameworks adaptable
for local use
• Case studies and examples of good practice
• “concise well written information”
NHS Networks contd/
- Key information requirements
• Understand local population
• needs assessment, demographics, health impact
assessment, equality assessment, public health
info, mortality

• Services
• How they are used, case studies and how to
develop locally, cost benefit, quality, prioritisation

• Clinical evidence
• Guidelines, service specs, competencies
3. The Intelligent Practice Dr Foster
• Published 2007 to support Practice Based
Commissioning (ie before recent health
service reorganisation)
• Intelligent information required – Strategy – health needs, market intelligence
– Choice & quality – patient experience
– Activity & finance
http://drfosterintelligence.co.uk/wp-content/uploads/2011/06/Intelligent-Practice-2007.pdf
4. Commissioning Intelligence Model
• Feedback on the results of a large-scale
government engagement exercise to understand
the information and intelligence requirements of
emerging CCGs
• Largely concerns data and intelligence eg clinical
and financial data integration tools; population
and patient risk stratification; data warehousing
solutions; and urgent care dashboards
• Includes important supporting Services, Tools and
Data
Commissioning Intelligence Model contd/

Segments:
1. How healthy?
2. What's really happening in
this system?
3. How much?
4. How do we compare?
5. Are my providers delivering
what they agreed?
6. How could things be better?
7. What difference have we
made?
8. What are our future plans?

Information /skills
required included:
• Specialist knowledge of
evidence sources and
research
• Identify tools
• Local population health
• What have other people
done? - incl £, KPIs
To summarise: Content
•
•
•
•
•
•
•
•
•

Authorisation
Government policy/ legislation and guidance
Expert guidance, templates, frameworks
Current services (both local and national) - activity &
financial data and analytical tools
Understand the population – statistics, demographics,
health needs and risk stratification
Market intelligence
Choice & quality – patient experience
Case studies and examples of good practice
Research and clinical evidence - Guidelines, service
specifications, competencies
To summarise: Format
• A single source of information with search
tools
• Practical guides
• Summarised and structured enabling readers
to move quickly from high level information to
detail
• Alerting services around all of the above
– Key to minimise the risk of missing critical
information (NHS and external)
How does the information fit together:
Commissioning Cycle
Briefing for GPs
Commissioning Show 2012, Dr Andrew Jones BMJ
Assessing Needs
Data
Prevalence
Morbidity & mortality
Risk factors & lifestyle
Clinical
Commissioning

Service access

Capabilities
Segment & trend analysis
‘Market’ Intelligence

Tools
Data collection & reporting
Design Service & Pathway
Knowledge
Existing pathways
Evidence synthesis

Clinical
Commissioning

Evidence summaries for
single interventions
HTAs

Capabilities
Pathway adaptation

Pathway development
Guideline enablement
Clinical Decision Making
Knowledge
Best practice guidance
Guidelines
Pathways
Clinical
Commissioning

Tools
Referential decision support
Order sets / care bundles

Clinical prompts
Integrated decision support
‘Just in time’ learning
Sources:
•

•

•

•
•

NHS Staff survey 2005
Information needs and concerns of NHS staff in order to inform the programme of
work to deliver the National Library of Health
http://nlhcms.library.nhs.uk/nlhdocs/NHS_user_survey_final_report.pdf
The Intelligent Practice: Understanding the information needs of GP
commissioners (Dr Foster 2007)
http://drfosterintelligence.co.uk/wp-content/uploads/2011/06/IntelligentPractice-2007.pdf
NHS Networks survey to support development of Commissioning Zone 2010
http://commissioning.pbworks.com/w/file/43994424/Info%20needs%20of%20co
mmissioners%20survey%20Analysis%20of%20responsesv11-7-10.pdf
Commissioning Intelligence model –based on a government engagement exercise
2011
http://www.england.nhs.uk/2012/02/03/commissioning-intelligence-report/
The Commissioning Cycle - a summary for GPs
A presentation outlining the stages of the cycle, with a description of the
knowledge, capabilities, tools and data available to support those stages. Based on
a presentation by Dr Andrew Jones, BMJ at Commissioning Show 2012
http://www.miltonkeynesccg.nhs.uk/resources/uploads/files/Commissioning%20C
ycle%20for%20GPs.ppt

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Information Needs of Commissioners, CHfL workshop May 2013

  • 1. Commissioning in the NHS Information needs of commissioners Anne Gray, Knowledge Officer, Milton Keynes CCG Commissioning Handbook for Librarians workshop May 2013
  • 2. Local HealthWatch CCGs NHS E ATs LAs Structure of the NHS Clinical Research Networks
  • 3. Relationship between organisations Advice and performance management
  • 4. Relationship between organisations Regulating and monitoring the quality of services
  • 5. Clinical Commissioning Groups • Consortia of general practices with responsibility for commissioning local health services across England. • Commissioning responsibilities include: – planning services, based on assessing the needs of the local population; • planned and emergency hospital care, • rehabilitation, • most community services and mental health and learning disability services. – securing services that meet those needs – monitoring the quality of care provided.
  • 6. Business needs • CCGs are businesses whose members are themselves small businesses – Requirements from authorisation eg financial management, leadership, capacity, sustainability, innovation – Activity in General Practice (eg referrals) is central to managing activity but GP (primary care) contracts are managed by NHS England NOT CCGs
  • 7. Information needs assessments 1. 2. NHS Staff survey tfpl 2005 NHS Networks survey to support development of Commissioning Zone 2010 3. The Intelligent Practice: Understanding the information needs of GP commissioners (Dr Foster 2007) 4. Commissioning Intelligence model -government engagement exercise 2011 And finally • Information needs around commissioning – presentation by Dr Andrew Jones, BMJ
  • 8. 1. NLH NHS Staff user survey (tfpl 2005) Re: service development in primary care Managers want information about • government policy and guidance • regulations • news • statistics and demographics • clinical/scientific/and technical information, • information about projects being undertaken by other trusts. Format • Summarised information and structured enabling readers to move quickly from high level information to detail. Alerting services • Highly valued • Important to minimise the risk of missing critical information both for NHS and external information.
  • 9. 2. NHS Networks survey 2010 • Support development of Commissioning Zone – 87 GPs, 133 PCT, 42 others • Most useful types of information 1. 2. 3. 4. 5. 6. 7. 8. Case studies Templates/business studies Practical guides Official expert guidance Analytical tools Legislation Frameworks Research • Both push (eg email) and pull content important (eg online)
  • 10. NHS Networks contd/ - User wish list • • • • • A single source of information Powerful search tools Email alerts Access to reliable up to date source data A range of templates, frameworks adaptable for local use • Case studies and examples of good practice • “concise well written information”
  • 11. NHS Networks contd/ - Key information requirements • Understand local population • needs assessment, demographics, health impact assessment, equality assessment, public health info, mortality • Services • How they are used, case studies and how to develop locally, cost benefit, quality, prioritisation • Clinical evidence • Guidelines, service specs, competencies
  • 12. 3. The Intelligent Practice Dr Foster • Published 2007 to support Practice Based Commissioning (ie before recent health service reorganisation) • Intelligent information required – Strategy – health needs, market intelligence – Choice & quality – patient experience – Activity & finance http://drfosterintelligence.co.uk/wp-content/uploads/2011/06/Intelligent-Practice-2007.pdf
  • 13. 4. Commissioning Intelligence Model • Feedback on the results of a large-scale government engagement exercise to understand the information and intelligence requirements of emerging CCGs • Largely concerns data and intelligence eg clinical and financial data integration tools; population and patient risk stratification; data warehousing solutions; and urgent care dashboards • Includes important supporting Services, Tools and Data
  • 14. Commissioning Intelligence Model contd/ Segments: 1. How healthy? 2. What's really happening in this system? 3. How much? 4. How do we compare? 5. Are my providers delivering what they agreed? 6. How could things be better? 7. What difference have we made? 8. What are our future plans? Information /skills required included: • Specialist knowledge of evidence sources and research • Identify tools • Local population health • What have other people done? - incl £, KPIs
  • 15. To summarise: Content • • • • • • • • • Authorisation Government policy/ legislation and guidance Expert guidance, templates, frameworks Current services (both local and national) - activity & financial data and analytical tools Understand the population – statistics, demographics, health needs and risk stratification Market intelligence Choice & quality – patient experience Case studies and examples of good practice Research and clinical evidence - Guidelines, service specifications, competencies
  • 16. To summarise: Format • A single source of information with search tools • Practical guides • Summarised and structured enabling readers to move quickly from high level information to detail • Alerting services around all of the above – Key to minimise the risk of missing critical information (NHS and external)
  • 17. How does the information fit together: Commissioning Cycle
  • 18. Briefing for GPs Commissioning Show 2012, Dr Andrew Jones BMJ Assessing Needs Data Prevalence Morbidity & mortality Risk factors & lifestyle Clinical Commissioning Service access Capabilities Segment & trend analysis ‘Market’ Intelligence Tools Data collection & reporting
  • 19. Design Service & Pathway Knowledge Existing pathways Evidence synthesis Clinical Commissioning Evidence summaries for single interventions HTAs Capabilities Pathway adaptation Pathway development Guideline enablement
  • 20. Clinical Decision Making Knowledge Best practice guidance Guidelines Pathways Clinical Commissioning Tools Referential decision support Order sets / care bundles Clinical prompts Integrated decision support ‘Just in time’ learning
  • 21. Sources: • • • • • NHS Staff survey 2005 Information needs and concerns of NHS staff in order to inform the programme of work to deliver the National Library of Health http://nlhcms.library.nhs.uk/nlhdocs/NHS_user_survey_final_report.pdf The Intelligent Practice: Understanding the information needs of GP commissioners (Dr Foster 2007) http://drfosterintelligence.co.uk/wp-content/uploads/2011/06/IntelligentPractice-2007.pdf NHS Networks survey to support development of Commissioning Zone 2010 http://commissioning.pbworks.com/w/file/43994424/Info%20needs%20of%20co mmissioners%20survey%20Analysis%20of%20responsesv11-7-10.pdf Commissioning Intelligence model –based on a government engagement exercise 2011 http://www.england.nhs.uk/2012/02/03/commissioning-intelligence-report/ The Commissioning Cycle - a summary for GPs A presentation outlining the stages of the cycle, with a description of the knowledge, capabilities, tools and data available to support those stages. Based on a presentation by Dr Andrew Jones, BMJ at Commissioning Show 2012 http://www.miltonkeynesccg.nhs.uk/resources/uploads/files/Commissioning%20C ycle%20for%20GPs.ppt

Notas del editor

  1. Authorisation –regulations, financial management, leadership, capacity, sustainability, innovationGovernment policy/ legislation and guidanceExpert guidance, templates, frameworks adaptable for local useServices (both local and national) - activity & financial data and analytical tools eg patient pathwayPopulation statistics, demographics, health needs and risk stratification of both of the local population and national for benchmarkingMarket intelligence – providers Choice & quality – understanding patient experience Case studies and examples of good practice from other trusts (high and low quality) including cost benefit, quality indicatorsResearch and clinical evidence - Guidelines, service specs, competencies