DH publication sets out updated timetable for NHS commissioning reforms
The Shared Operating Model for PCT Clusters, published this week by the Department of Health (DH), shows how commissioning will work during the transition period and covers the development of GP-led clinical commissioning groups (CCGs), or consortia as they have been more widely known.
The document sets out the need for moving towards a more consistent way of operating in some areas as we move through transition and prepare for the establishment of the NHS Commissioning Board
A DH spokesman said: "This publication supports the development of PCT clusters to help ensure they deliver their twin objectives of overseeing and accounting for delivery during transition and supporting the development of the new system. The document sets out the need for moving towards a more consistent way of operating in some areas as we move through transition and prepare for the establishment of the NHS Commissioning Board (NHSCB). Structured around six key business areas, it also sets out where there are processes or functions that all PCT clusters will need to perform and where it is important that there is consistency between them."
The report says clusters should 'exploit opportunities to improve efficiency. [and] streamline and centralise some functions or processes [but] ensure they have sufficient management capacity so that accountability can be maintained'. The guidance goes on to state: "Cluster chief executives must ensure there are appropriate arrangements in place for effective planning for 2012-13, enabling emerging CCGs to lead the planning round where they are ready and willing to do so."
This publication supports the development of PCT clusters to help ensure they deliver their twin objectives of overseeing and accounting for delivery during transition and supporting the development of the new system
It includes a requirement for all GP practices to be members of a CCG by April 2012 and indicates there will be a quick move to decide on CCG boundaries. It is understood that this could result in some pathfinder groups being told they are too small or do not cover a clear enough geographical area. And the document also includes confirmation that commissioner communications and engagement will be quickly centralised under a 'single, locally focused, nationwide shared service', claiming this is necessary because in many PCTs communications staff have already left and the new system as a whole will be under more media and public scrutiny.
Key milestones to come in the next few months, according to the document, are:
- By August 2011:
PCT clusters will have started to delegate 'a clear percentage of budgets' to CCG pathfinders - By September 2011:
PCT clusters will have undertaken patient engagement and have determined services of choice for Any Qualified Provider.
Clusters should ensure they prepare, and keep up to date, their own cluster-wide legacy document ready to handover to SHAs on the 5th September.
Clusters and SHAs will begin phase two of their commissioning support business review.
Clusters will have identified staff currently involved in directly commissioning primary care, specialised, prison health, and military services. Clusters will have ensured current Prison Health Needs Assessments remain fit for purpose and have been revised accordingly for use in the 2012/13 commissioning round.
Clusters will have an input into the development of a single approach to primary care contract performance management for delivery by April 2012.
Clusters will have identified how they provide the services described in the draft national FHS schedule and the staff involved in this work. They should also establish how they are linked into the national work and from this how they are moving to standardising their services across the cluster in the way described in the draft national specification. It is envisaged that, by December 2011, they will have achieved standardisation within the cluster and have clear plans for rationalisation where appropriate.
Clusters, in collaboration with their specialised commissioning groups, will have used a single national algorithm to separate specialised and non-specialised elements of activity in every acute/mental health contract according to planned activity for 2011/12, allowing high-level financial risk management to take place on a contract-by-contract basis.
Clusters, in collaboration with their specialised commissioning groups, willhave identified all services that are currently commissioned by PCTs, but are included in the specialised service national definition set and migrate these to specialised commissioning group responsibility
All CCG pathfinders will have completed self diagnostic or recognised equivalent
Clusters will have ensured a clear percentage of budgets is delegated to CCG pathfinders, with a trajectory for future delegation.
All GP practices will be within an emerging viable CCG. Clusters will support agreed Right to Request proposals to become successful establishments.
Clusters will have signed off priority Any Qualified Provider services with SHAs. Regional communication and engagement hubs will be established in line with SHA clusters. This goes hand-in-hand with establishing interim management of the locally-delivered, nationwide shared service in the autumn.
Clusters should have identified secondary care activity usage by prison and custodial services from new data flows and use it to inform commissioning plans.
Clusters will have separately identified prison health secondary contract activity by service, speciality/HRG, value and provider.
Clusters will have identified secondary care activity usage by armed forces from new data flows and use it to inform commissioning plans.
Clusters to have separately identified military health secondary care activity by service, speciality/HRG, value and provider - By December 2011 :
Clusters will have agreed with their prospective CCGs their do/share/buy options and their commissioning support requirements.
Clusters will have completed cataloguing existing contracts for primary care, prison and custodial health and offender health, local agreements and enhanced services for medical, dental, optical and pharmaceutical services according to a national template setting out the broad contents of the contracts and their state of readiness for handover to the NHSCB
Clusters will have completed a cataloguing of the primary care premises according to a national template to ensure that the NHSCB has a robust record of the current primary care estate. - By January 2012 :
Clusters will ensure constituent PCTs have published information and evidence to demonstrate their compliance with the Equality Duty, including information relating to employees thereafter at least annually. - By March 2012:
Clusters will have completed the commissioning support business review phased process.
Clusters will be operating direct commissioning functions in line with an agreed shared operating model.
Clusters will have mapped their specialised commissioning functions onto the NHSCB future organisational structure.
Clusters will support CCGs to ensure they are actively engaged in the development of their local health and wellbeing board - By April 2012:
Clusters will start delivery of at least three Any Qualified Provider community and mental health services, working in partnership with CCGs
A Locally-delivered nationwide shared communication and engagement service will be fully functioning
Clusters will begin to move towards a single process for primary care contract performance management to ensure all are following the same process by April 2013.
Clusters will migrate staff to a single specialised commissioning team
By 6 April, clusters will have to ensure their constituent PCTs publish Equality Objectives - By May 2012 :
Clusters will provide feedback on constituent PCTs' providers' Quality Accounts
Clusters will ensure constituent PCTs publicly report on the incidence of 'never events' as part of their annual reporting on quality