December 2010 - new commissioning toolkit from the RCGP Commissioning Federation
23 June 2010 Two complementary documents have been launched on GP commissioning. Giving GPs budgets for commissioning: what needs to be done? A discussion paper comes from 6 influential policy organisations: NHS Alliance, Nuffield Trust, Kings Fund, RCGP, NAPC, NHS Confederation. Given experience and evidence, this new paper covers important ground about budget-setting, balancing risk, reward, dealing with failure (including avoiding the risk of random health care events tipping a group into financial failure), the scope (eg managing GMS and PMS contracts too and enabling consultant contracts to be altered to enable them to become part of commissioning groups), scale (they recommend 100,000 population) and how to support it and postulates a three-tier model of GP commissioning: Tier 1 The innovators - a relatively small group of like-minded practice-based enthusiasts who are prepared to pilot full risk-bearing Tier 2 Real budget-holding for some services for all patients, including those patients whose own GPs opt out, and including some mandatory sevices like urgent care. Tier 3 Provider-only primary care where GPs get autonomy but also performance management by their peers. Their commissioning would be done by a GP commissioning group or by a private provider nominated by the Independent NHS Board.
Developing GP Commissioning - a new form of local clinically led and empowered commissioning from the NHS Alliance. This describes the "The co-operative model, which sees profits ploughed back into patient care rather than to individuals [and] means that local clinicians could come together as ‘local clinical partnerships’ co-operating to provide best possible care. These local clinical partnerships (of GPs, specialists, nurses, pharmacists, allied professionals and others) working through the GP Commissioning consortia, would essentially be a ‘team without walls’ and would provide an increasing amount of care locally (and more cost effectively). This builds on work we've seen before from NHS Alliance and Minoo Irani and recognises the need to consider clinical partnerships, and for good make/buy decision-making: what to provide as a team and what to commission from others. Both papers call on the DH England to accept a range of models and to clarify rewards, risks and responsibilities.
June 2009 The Department of Health in England has published a practical guide for GPs to Practice-based Commissioning. It includes a COPD example from Easington Practice in County Durham that describes how they worked from data analysis to service design, working closely with the PCT, to optimise use of community services, self management to reduce hospital admissions. March 2009, the Department of Health in England has announced several new initiatives to invigorate clinical commissioning (or practice-based commissioning – PbC) which is largely regarded as insufficiently active around the country. These are:
For further information see here.