The NHS Commissioning Board Authority has published the single operating model for the commissioning of primary care services within the NHS.
The new system will come into effect from 1 April 2013. At this date, the NHS Commissioning Board will take on many of the current functions of PCTs with regard to the commissioning of primary care health services, as well as some nationally-based functions currently undertaken by the Department of Health.
Securing excellence in commissioning primary care describes the system by which the NHS Commissioning Board will use the £12.6bn the NHS spends on commissioning primary care to secure the best possible outcomes for patients. In time, through this new system, the NHSCB will also develop the future strategy for primary care.
The benefits the Board Authority hopes to achieve from this change are:
- Greater consistency and fairness in access and provision for patients, with an end to unjustifiable variations in services and a reduction in health inequalities
- Better health outcomes for patients as primary care clinicians are empowered to focus on delivering high quality, clinically-effective, evidence-based services
- Greater efficiencies in the delivery of primary care health services through the introduction of standardised frameworks and operating procedures.
It is a system change which will have an impact on patients, providers and their teams, and commissioners, and the Board Authority has systematically taken 18 months to research, develop and consult upon the proposals to ensure they are practical and workable. It has worked closely with current commissioners, patient representatives, PCT medical directors, dental, pharmaceutical and optometric advisors, and key national, regional and local stakeholder and professional bodies to seek to understand and preserve the best of the current system, learn from good practice, and ensure that the system changes will be managed effectively.
The document is based on three guiding principles:
- People should have access to continuously improving, high quality primary care provision regardless of where they live
- The commissioning system should be clinically led and professionally managed to balance the needs of local communities within a single operating system
- There should be consistency in the contractual relationship between providers and the NHS Commissioning Board as the commissioner.
Over the next few months, local area teams, which will be responsible for the delivery of the new system, will be appointed as will central and regional primary care commissioning teams. CCGs, commissioning support services and local authorities will start to assume their future roles and responsibilities. This document will provide a guide these teams and bodies as they establish and/or further develop their organisations.
- Securing excellence in commissioning primary care
- Securing excellence in commissioning primary care: Annex 2 Tasks and functions
- Securing Excellence in Commissioning Primary Care: Key Facts
- Securing Excellence in Commissioning Primary Care – frequently asked questions
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Can you please clarify the relationship between the NHSCB and NHS Property Services in relation to premises especially in respect of strategic estate development.
Hi Jill. The relationship between NHSCB and NHS Property Services is in the process of being developed. At the moment the NHSCB anticipate that there will be a commercial relationship with NHSPS; where NHSPS will own the properties and incur associated costs and then charge us an economic rent on each property. Strategic estates will be a service that is provided which others and we will need to buy.
Just a thought but wouldn’t it have been clearer to call the single operating model for Commissioning Primary Care the single operating model for Commissioning Primary Care rather than securing excellence in commissioning primary care?
In Primary Care there is much needed guidance on the contracts gp’s hold with their PCT. Traditionally this was a contract between a gp and the FHSA, now PCT and stems back from an NHS law in 1948. However whilst in general the DOH encourages formation of partnerships and an different models of care, notably GMS, PMS and APMS it appears that the latter are up to two yearly renewals whilst the former two, GMS and PMS seem to be nearly untouchable, except when a gp retires or is not able to stay on the performers list. The problem arises for single handed practices who can take them over: will that be a transparent tendering process or will these single handed practices be able to deal and wheal with other local practices to form a partnership. The situation creates huge uncertainty, not only for young doctors who come into general practice but also for the commissioners and providers who want to drive quality upwards. In Hull, where I work, but there without doubt be many other places where it has traditionally been difficult to recruit gp’s, this creates with immeninent retirements on the horizon, serious problems in health care provision in the near foreseeable future.
Does the DOH have views on this?
Hi
Thank you for your comment.
The proposals set out in the document on future commissioning arrangements for primary care services are those of the NHS Commissioning Board Authority, rather than the Department of Health. As of 1 April 2013, the NHS Commissioning Board will inherit the current contractual arrangements that apply to GP practices.
The Board will wish to move over time towards more consistent, equitable arrangements that support continuous improvements in quality and outcomes and help reduce inequalities in access to primary care. In addition, the Board will also wish to work with the profession and with others to identify any more immediate actions that can be taken to support quality improvement and innovation.
Kind regards
Simon
Whilst the paper notes different contract types for GP primary care services and talks about continuous quality improvement, it makes no reference to dealing with the long standing anomaly that practices in the same area serving the same population need are allocated financial resources to provide competent staff etc differently. Allocation is based on historic agreement not on fair share allocation. Whilst some PCTs have adopted systems of movement to fair share for primary care allocations this is not universal. Is it not appropriate with the formation of a National primary care commissioning body to address this in order to practically support equity in access to quality care, provide a level playing field for quality improvement and demonstrate value of the use of public money?
Hi
Thank you for your comment.
As of 1 April 2013, the NHS Commissioning Board will inherit the current range of contractual arrangements that apply to GP practices. The Board will wish to move over time towards more consistent, equitable arrangements that support continuous improvements in quality and outcomes and help reduce inequalities in access to primary care.
Kind regards
Simon