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‘Route map’ outlines steps to person and community centred commissioning

‘Route map’ outlines steps to person and community centred commissioning

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Exclusive A group of frontline commissioners have uncovered the three key elements to focus on when building person and community centred commissioning

Developed by members of NHS Clinical Commissioners’ Person and Community Centred Commissioning (PC3) Network, a newly released route map highlights the importance of “commissioning differently”. 

According to the route map, the key steps in introducing person-centred commissioning are making the adoption journey, recognising the things that are different when doing person centred commissioning (compared to what used to happen) and building capability to deliver the new approach at scale. 

Based on published commissioning research and grey literature, the Network’s guide claims that the ‘adoption journey’ is a process of learning, improving and refining, with a group of like-minded people championing the work. 

But the first step is being dissatisfied with the current commissioning model, the group claimed. 

Dr Andy Lee, a clinician who has helped drive person-centred commissioning in North Lincolnshire clinical commissioning group (CCG) said: "We wanted to adopt a new approach to commissioning that enabled us to involve our community to an extent that has not happened before. At the same time, we wanted as many of our partner commissioners and our providers to share in this new approach."

By developing a new conceptual framework for commissioning, then applying it on a small, low scale risk and learning throughout, a CCG can eventually spread the idea of person centred commissioning across their organisation, according to PC3. 

The roadmap also explains the “critical differences” between the usual commissioning cycle and one which is person-centred. 

For example, a person-centred CCG would have board papers presented in formats that anyone could understand and do its commissioning design work through workshops or meetings that the public could easily participate in. 

'Different skills'

Person-centred commissioning would also ensure that care pathways are based on relationships rather than built around clinical processes, with providers held to account for whether they are delivering outcomes and person-centred care within a culture that supports this. 

Speaking to The Commissioning Review, Dr Niti Pall, long term conditions lead for Sandwell and West Birmingham CCG said: “It is essential that we measure what matters and not just what is easy to count. That is the essence of Francis – and the contracting models we use need to reflect this.” 

The route map states: “Our research tells us that in order to operationalise person-centred commissioning, CCGs need to behave and commission differently. This means they need different skills, organisational capacity and re allocate capacity – not necessarily more.” 

Some examples of building capacity described as “essential” by PC3 are: 

Values and purpose

- Demonstrating values-based leadership

- Proactively building consensus through constructive collaboration focused on delivering change and improvement for and with local people 

Needs assessment and assets mapping 

- Using participatory needs assessment processes that enables local people to engage as experts by experience 

- Gathering insights from local people and frontline staff about what is working and what we can improve

Service planning 

- Designing person-centred outcome measures that capture what matters to people 

- Understanding service ‘value’ and when decommissioning, retaining that value by delivering it in a different  (more sustainable) way

Contracting 

- Designing values-based, outcomes focused contracts that promote provider collaboration and relationship based care

- Applying collaborative, values-based contracting models 

Monitoring 

- Involving people who use services and deliver them, as well and GPs, in monitoring 

- Leading change through ‘bite-sized’ improvements that together create transformation and keep partners and local people engaged

Review

- Holding providers to account by them evidencing progress and improvement based on person-centred outcome measures

- Using Commissioning for Quality and Innovation payments and non-financial levers to drive person-centred improvement

The full road map is available to view on the NHS Clinical Commissioners website.

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