Imelda McDermott, K. Checkland, A. Coleman, L. Warwick-Giles, S. Peckham, D. Bramwell, V. Moran, Oz Gore
{"title":"Commissioning Primary Care Services: Concepts and Practice","authors":"Imelda McDermott, K. Checkland, A. Coleman, L. Warwick-Giles, S. Peckham, D. Bramwell, V. Moran, Oz Gore","doi":"10.46692/9781447346128.005","DOIUrl":"https://doi.org/10.46692/9781447346128.005","url":null,"abstract":"Chapter 5 reports research on the more recent policy of allowing CCGs to commission primary care services. In 2014 CCGs were invited to volunteer to take on responsibility for commissioning services from their member GP practices in addition to their wider responsibilities for commissioning acute and community services. In this chapter we explore the history of primary care commissioning and financing in England, and discuss the broad policy objectives which underpinned this significant change in CCGs role and scope. These objectives include the need to move to a ‘place-based’ approach to commissioning, and the need for a more effective linkage between the commissioning of primary and secondary care services in order to support movement of services into the community. Over time, most CCGs have moved to take on full delegated responsibility for commissioning GP services, and have established functioning primary care commissioning committees, with little evidence of significant problems associated with conflicts of interest. The development of local additional ‘quality contracts’ and investment in infrastructure and premises have been important issues, with few CCGs seeking to establish larger scale contractual changes. There have been significant local legacy issues in some areas relating to unclear contracts and poor handover of responsibilities from NHS England. The current legislation, under which statutory responsibility for commissioning primary care services remains with NHS England and is delegated rather than transferred to CCGs, presented some problems, particularly for those CCGs who wished to work together across a broader geographical footprint.","PeriodicalId":115287,"journal":{"name":"Commissioning Healthcare in England","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134410534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Imelda McDermott, P. Allen, V. Moran, A. Coleman, K. Checkland, S. Peckham
{"title":"Context: Commissioning in the English NHS","authors":"Imelda McDermott, P. Allen, V. Moran, A. Coleman, K. Checkland, S. Peckham","doi":"10.46692/9781447346128.002","DOIUrl":"https://doi.org/10.46692/9781447346128.002","url":null,"abstract":"Chapter 2 provides the context, setting out the organisation and governance of commissioning in the NHS. It includes a short summary of the architecture of commissioning pre-Health and Social Care Act (HSCA12), and highlights the important changes which were brought about by the Act, including the abolition of Primary Care Trusts and Strategic Health Authorities, the establishment of Clinical Commissioning Groups (CCGs), the creation of NHS England, transfer of commissioning responsibilities to different bodies (e.g. public health) and the setting up of local Health and Wellbeing Boards. The chapter also highlights the programme theories underlying the HSCA12, in particular the commitment to competition as a means of improving services and the expected benefits of greater clinical involvement in commissioning.","PeriodicalId":115287,"journal":{"name":"Commissioning Healthcare in England","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133984832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Peckham, A. Coleman, E. Gadsby, J. Segar, Neil Perkins, D. Bramwell
{"title":"The Changing Public Health System: an Examination of the new Commissioning Infrastructure","authors":"S. Peckham, A. Coleman, E. Gadsby, J. Segar, Neil Perkins, D. Bramwell","doi":"10.46692/9781447346128.008","DOIUrl":"https://doi.org/10.46692/9781447346128.008","url":null,"abstract":"Chapter 8 reports research on the changing role of commissioning in the restructured public health system. The chapter will discuss how public health commissioning responsibilities have changed and become more fragmented, being split amongst a range of different organisations, most of which were newly created in 2013. It will focus on discussing how the re-organisation substantially changed the way public health commissioning is done, who is doing it, and what is commissioned, since the reforms. There have been significant changes in commissioning processes, with important consequences for what health improvement services are ultimately commissioned. Also new opportunities for creativity and joining public health with wider determinants of health (e.g. housing and leisure).","PeriodicalId":115287,"journal":{"name":"Commissioning Healthcare in England","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127209666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Conclusion","authors":"Pauline Allen, K. Checkland, S. Peckham, V. Moran","doi":"10.46692/9781447346128.009","DOIUrl":"https://doi.org/10.46692/9781447346128.009","url":null,"abstract":"","PeriodicalId":115287,"journal":{"name":"Commissioning Healthcare in England","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127438594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Conclusion","authors":"P. Allen, K. Checkland, S. Peckham, V. Moran","doi":"10.1332/policypress/9781447346111.003.0009","DOIUrl":"https://doi.org/10.1332/policypress/9781447346111.003.0009","url":null,"abstract":"Chapter 9 draws together key themes arising from the book about issues raised by commissioning in the context of a quasi-market for healthcare in the English NHS, such as governance and accountability, clinical engagement, co-ordination and fragmentation. The chapter presents an overview of how commissioning in health and healthcare has developed since 2010 and what the implications are for the future in the light of recent developments moving away from market style mechanisms to forms of local collaborative planning.","PeriodicalId":115287,"journal":{"name":"Commissioning Healthcare in England","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122071714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Checkland, A. Coleman, Imelda McDermott, Rosalind Miller, S. Peckham, J. Segar, S. Harrison, Neil Perkins
{"title":"Clinical engagement in commissioning: past and present","authors":"K. Checkland, A. Coleman, Imelda McDermott, Rosalind Miller, S. Peckham, J. Segar, S. Harrison, Neil Perkins","doi":"10.46692/9781447346128.004","DOIUrl":"https://doi.org/10.46692/9781447346128.004","url":null,"abstract":"Chapter 4 looks at the evidence about clinical engagement in primary care-led commissioning. Extending and strengthening clinical leadership was one of the key elements of the HSCA12. However, this idea was not new, and this chapter reviews the evidence on the role of clinicians in primary care-led commissioning and how this has contributed to the delivery of healthcare services since the early 1990s. It examines the nature of clinical engagement/involvement in the various primary care-led commissioning models that have been introduced into the NHS. Drawing on a review of the literature and our research on Clinical Commissioning Groups the chapter shows how the extent of clinical engagement has varied between the various schemes. GP commissioners have historically been more successful in influencing the work done by GP practices than in making broader changes to services provided by secondary care. The chapter goes on to explore the claims made both by those involved and in official documents about how greater involvement of clinicians in CCGs – and in particular GPs – will enhance commissioning practice. We test this against evidence from our study of CCGs, showing how the engagement and involvement of GPs requires careful attention to detail. Using a realist approach to evaluation, we highlight the contexts and mechanisms associated with successful – and unsuccessful – GP involvement in commissioning.","PeriodicalId":115287,"journal":{"name":"Commissioning Healthcare in England","volume":"212 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114058327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Conclusion","authors":"Pauline Allen, K. Checkland, S. Peckham, V. Moran","doi":"10.2307/j.ctvz938mt.15","DOIUrl":"https://doi.org/10.2307/j.ctvz938mt.15","url":null,"abstract":"","PeriodicalId":115287,"journal":{"name":"Commissioning Healthcare in England","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117160441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Checkland, A. Coleman, Imelda McDermott, Rosalind Miller, S. Peckham, J. Segar, S. Harrison, Neil Perkins
{"title":"Clinical engagement in commissioning:","authors":"K. Checkland, A. Coleman, Imelda McDermott, Rosalind Miller, S. Peckham, J. Segar, S. Harrison, Neil Perkins","doi":"10.2307/j.ctvz938mt.10","DOIUrl":"https://doi.org/10.2307/j.ctvz938mt.10","url":null,"abstract":"","PeriodicalId":115287,"journal":{"name":"Commissioning Healthcare in England","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130809206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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