Commissioning Capability Programme

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1 Name of Author: Sponsoring Director and/or Clinician: Locality Affected: Practices Affected: Caroline Gregory, Chief Financial Officer Nicki Millin All All Purpose and Reasons To achieve the objectives set out in the NHS Five Year Forward View, NHS England (NHSE) requires commissioning capabilities that can deliver better care and health at lower cost. Whilst the strategic focus of NHSE remains on developing a programme to help organisations migrate towards new models of care, feedback from the system has highlighted a here and now need to build the longer-term capability of senior commissioners in the health and care system. Accordingly, NHSE has been investing in a major capabilities building programme for senior commissioning leadership to help these leaders develop the skills they need to tackle today s and tomorrow s challenges across the health system. They selected the Optum Alliance through a competitive tender process as the preferred supplier; this is formed from Optum Health Solutions and PricewaterhouseCoopers. The has been established to improve CCG capability across five learning streams that address core areas essential to CCG success: Building a sustainable strategy Financial planning and recovery Governance Execution and implementation Managing and influencing stakeholders 1.5 Over a period of twelve weeks, the programme focuses on supporting participants capability development across each of the learning streams, through one to one coaching, workshops, and access to learning materials and resources. Page 1 of 6

2 2. Recommendations Governing Body is recommended to: 2.1 Note the which the Accountable Officer and Executive Directors from the CCG participated in along with its achievements, future objectives and action plan. 3. Detail BaNES, Swindon and Wiltshire CCG s were invited to take part in the by NHSE. There was recognition that these three CCG s are now part of the BaNES, Swindon and Wiltshire Sustainability and Transformation Partnership (BSW STP), however due to the disparate geographical footprint and complex population flows, the opportunities for working collaboratively had not been fully explored. Further to this, relationships between participants, below the Accountable Officers (AOs), had not been fully established and cross CCG working was not commonplace. There was seen to be an opportunity to collaborate to improve whole system working and realise the benefits of at scale commissioning and it was anticipated that the outcomes of this programme would help equip the CCG leadership with the capability they need to make a significant, long term difference to the quality of healthcare in BaNES, Swindon and Wiltshire and maximise the efficient use of public money. It was understood that the CCG leadership had ambitious plans to transform their system into a vibrant and diverse integrated care system by 2020 and, as a result of this programme, should be a position to expedite progress towards this ambition. From an initial scoping exercise, the programme was tailored to focus on: Page 2 of 6

3 Priority areas of focus within each learning stream Learning Stream 1. Building a sustainable strategy 2. Financial planning and recovery Areas of development focus identified from scoping review The whole system strategy needs to be clearly developed and articulated and consider the move towards integrated commissioning. The CCGs to focus on how to communicate it succinctly to different audiences, as well as support in taking it from plan to action The CCG s would like to further develop their whole system financial strategy, specifically the impact of integrated commissioning and exploring new models for providers outside of PBR 3. Governance Build on and optimise the current arrangements to ensure whole system governance is fit for purpose and has the capability to interface with future models of commissioning 4. Executing and implementation 5. Managing and influencing stakeholders The CCG s have a track record of delivery therefore this learning stream is not a priority Work alongside providers to build trust as equal partners in a new, more integrated system and explore operating and business models that incentivise and enable the transformation Dial up/dial Down (H/M/L) Percenta ge of program me time to be spent on stream H 30% M 20% H 30% L 0% M 20% Page 3 of 6

4 3.6 Programmes Achievements Building a Sustainable Strategy Outputs included: determining a clear mission statement for the three CCG s agreement on commissioning at scale across BSW and to commit the resource and budget to developing the chosen direction of travel establishment of a Commissioning Alliance to drive forward the initial phase of work the need to ensure a consistent communications and engagement plan for staff and stakeholders Financial Planning and Recovery Outputs included: key workstream to include in the Financial Recovery Plan being length of stay where there are significant savings to be made development of a delivery plan for the reduction of length of stay by the 30 th of June three CCGs to understand how the future way of working will impact on their own financial position and that of the system, to contribute meaningfully to a sustainable financial strategy. Governance Outputs included: how the system will work together in the future when commissioning at scale and consideration of different options clarity on the principles of good system governance the development of the model of the preferred governance option and a set of proposals to be presented to a joint Governing Body development session on the 4 th of October. 3.7 Future Objectives These were defined as: prioritising the development of the roadmap for the future state of commissioning which will be driven through the newly formed Commissioning Alliance for a set of propositions to take to a joint Governing Body meeting alignment of governance structures and joint committees across BSW to drive forward commissioning at scale with a working group Page 4 of 6

5 established to identify the differences between the three CCG s current governance arrangements and work together to align them focus on working with the wider system as other system leaders need to be key partners in agreeing what the model for commissioning at scale looks like 3.8 Action Plan The NHSE Regional Leads have identified a set of Nationally-available programmes and offers to support the CCG with their objectives and ongoing development. The BSW CCGs have taken advantage of this by agreeing to a specific piece of work to develop the options for commissioning at scale which will be taken to the three CCGs Governing Body development session on the 4 th October Alternative Options None 5. Implications, Equality & Diversity Assessment and Risk Management 5.1 Patient Benefits 5.2 Safety and Quality Impact 5.3 Financial and Procurement Implications 5.4 Legal and Human Rights Implications 5.5 All other Implications (including Staff, Sustainability, Health, Rural, Crime and Disorder) None 5.6 Equality & Diversity Impact Assessment None 5.7 Risk Management Page 5 of 6

6 6. Consultees 6.1 None 7. Background Papers 7.1 None 8. Appendices 8.1 : End of Programme Summary BaNES, Swindon and Wiltshire CCGs Page 6 of 6