Commissioning is the continual process of planning, agreeing and monitoring services. Commissioning is not one action but many, ranging from the health-needs assessment for a population, through the clinically-based design of patient pathways, to service specification and contract negotiation or procurement, with continuous quality assessment.
There is no single geography across which all services should be commissioned: some local services can be designed and secured for a population of a few thousand, while for rare disorders, services need to be considered and secured nationally
In some areas of the Fylde Coast, especially central Blackpool and Fleetwood, people have poor health compared to the national average.
There are many things which can improve health, but the biggest impact can come from people themselves. As clinical commissioning groups we have a role to play in supporting people to make healthy choices.
With our partners we are working to:
- Improve health and wellbeing
- Ensure high quality health and care services
- Use the budgets we have most effectively
As the population ages, the health service needs to change to meet people’s changing healthcare needs. More and more people are living with a number of long-term health conditions, and benefit from ongoing support to keep well.
We have to live within our means, just as households across the Fylde Coast have to live within their household budgets. Therefore we need to focus our efforts on where we can make the biggest impact to people’s health and wellbeing, and not spend money on things which have little evidence of good outcomes.
People have told us they want:
- More support to help them better manage their long-term conditions
- Coordinated care so they don’t have to repeat their medical history unnecessarily
- Timely and appropriate care in community settings where possible
- Less unnecessary time spent in hospital
There is a lot of change ongoing across the public and third sector to bring services together. People often fall through the gaps which exist between organisations, and bringing services and teams together will stop this.
The organisations which commission and deliver services are becoming more joined-up across geographical ‘places’. For example, some local services can be designed and secured for a population within a neighbourhood, close to where people live. Specialist services for rare conditions should be planned on a larger geographical footprint, and should only available at specialist centres where they can be delivered most safely.
There are three geographical ‘places’ for commissioning and delivering health and care services locally. These are:
The change people will see and experience most vividly is within neighbourhoods – geographical areas of typically 30,000 to 50,000 residents. Neighbourhood care teams bring groups of GP practices together with community health services, social care, mental health services, and others, to provide a joined-up health and wellbeing services. Working together in this joined-up way, the teams can make a complete assessment of a person’s health, wellbeing and social needs and liaise with their colleagues to make sure they receive the right support.
NHS England has developed a very helpful three-minute video about how health and care services are changing across the country to become more joined-up (i.e. more integrated).