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AHP Contribution to Commissioning

Up to Input to Healthcare Commissioning Network
July 14. 2011
Christine Whittaker

We would very much welcome people's comments on the information listed below. We have a very short window in which to proactively influence the estblishment of the new clincial commissioning consortia. Comments/suggestions/additions/deletions via the forus asap would be much appreciated.

 

AHP comments re contribution to commissioning

 

 

Overarching Key message:

Commissioning processes will benefit from liberating and harnessing clinical intelligence at every level to increase the effectiveness of all aspects of the commissioning cycle including joint strategic needs assessment. 

 

Commissioners will need a visible and accessible route to accessing clinical intelligence which may not always sit at the senior level of corporate structures and is frequently embedded within operational service delivery.

 

Whilst consortia will make local arrangements, it will be of benefit for there to be a strong requirement for all arrangements to enable the drawing-in of the clinical intelligence required for innovative and effective commissioning.  This intelligence may sit outside and not be known to those within the structure of commissioning teams.

 

Consortia should have a clear requirement to operate open, inclusive and pro-active processes for reaching-out to harness clinical advice and leadership.

 

AHP contribution (4 themes):

 

Choice and competition

AHPs offer specialist knowledge to assess commissioned services for effective communication; accessible information and methods for negotiating patient defined outcomes with service users enabling choice and placing service users at the centre of a process to define their desired outcomes.

 

AHPs can provide specialist clinical advice on quality and clinical standards to commissioners and service users.  Clinically informed benchmarks of quality will be essential to enable informed choice and competition based on quality across diverse providers.  For example:

  • some patient advocacy bodies have an historical stance of making blanket recommendations/demands for interventions to be delivered by a ‘qualified specialist clinician’ regardless of the sometimes improved outcomes and cost-effectiveness of interventions being delivered by trained and supported generic, community-based workers where this has been evidenced.
  • High-tech aids to communication and daily living can appear most attractive to service users and families when low-tech solutions may provide the most effective support in the context of the service users’ needs and environment.  AHP knowledge enables service users and commissioners to make an informed choice of aids which will provide the greatest functional support and access to social and daily activities making best use of NHS/local authority/personal funds

 

Accountability and patients

Being accountable for commissioning quality and budgets, consortia will need the specialist knowledge of a wide range of healthcare professionals.  AHP knowledge will enable commissioning to extend beyond a disease-based model to one that integrates social and educational methods with bio-medical interventions.  This will deliver economies of scale by ensuring that services are embedded in social and community settings, close to home and as a part of daily living, thus improving patient and family experience and avoiding unnecessary admission to hospital.

 

Commissioning processes and teams will benefit from the specialist skills that AHPs bring to maximise patient participation in the commissioning process to improve the accountability of the commissioning process to patients.  AHPS also offer specialist knowledge to evaluate proposed pathways/models of care for the maximum participation of patients/service users in the delivery of their care.

 

 

 

 

 

Education and Training

AHPs have a strong history of delivering interventions through others around the patient by delivering robust training and support.  Their skills in defining the competencies required in the whole workforce and the boundaries between interventions that can be safely delivered by family and community, trained but ‘unqualified staff, and professionally registered staff only will be critical in defining education and training strategies to develop the whole workforce to deliver innovative, integrated services.

 

Advice and leadership

A key benefit of having AHP’s included in the commissioning process is the problem solving nature of their and competencies. They are less likely to instinctively try and reproduce what has been done before, but will look for practical ways to solve real problems within a pathway of care.  Making processes more efficient and using innovative ideas to improve a patient’s function translates well into redesigning patient care pathways.

 

AHPs are experienced in delivering models of intervention that work across organisational and agency boundaries including health, social care, the voluntary and private sector.  They have skills to navigate across boundaries that should be harnessed in pathway redesign.

 

In order to access such intelligence, commissioners will need to be open to questioning assumptions about care pathways; sources of clinical advice and ‘knowing what they don’t know’.

 

 

 

July 14. 2011
Dawn Smith
Previously Christine Whittaker wrote:

We would very much welcome people's comments on the information listed below. We have a very short window in which to proactively influence the estblishment of the new clincial commissioning consortia. Comments/suggestions/additions/deletions via the forus asap would be much appreciated.

 

AHP comments re contribution to commissioning

 

 

Overarching Key message:

Commissioning processes will benefit from liberating and harnessing clinical intelligence at every level to increase the effectiveness of all aspects of the commissioning cycle including joint strategic needs assessment. 

 

Commissioners will need a visible and accessible route to accessing clinical intelligence which may not always sit at the senior level of corporate structures and is frequently embedded within operational service delivery.

 

Whilst consortia will make local arrangements, it will be of benefit for there to be a strong requirement for all arrangements to enable the drawing-in of the clinical intelligence required for innovative and effective commissioning.  This intelligence may sit outside and not be known to those within the structure of commissioning teams.

 

Consortia should have a clear requirement to operate open, inclusive and pro-active processes for reaching-out to harness clinical advice and leadership.

 

AHP contribution (4 themes):

 

Choice and competition

AHPs offer specialist knowledge to assess commissioned services for effective communication; accessible information and methods for negotiating patient defined outcomes with service users enabling choice and placing service users at the centre of a process to define their desired outcomes.

 

AHPs can provide specialist clinical advice on quality and clinical standards to commissioners and service users.  Clinically informed benchmarks of quality will be essential to enable informed choice and competition based on quality across diverse providers.  For example:

  • some patient advocacy bodies have an historical stance of making blanket recommendations/demands for interventions to be delivered by a ‘qualified specialist clinician’ regardless of the sometimes improved outcomes and cost-effectiveness of interventions being delivered by trained and supported generic, community-based workers where this has been evidenced.
  • High-tech aids to communication and daily living can appear most attractive to service users and families when low-tech solutions may provide the most effective support in the context of the service users’ needs and environment.  AHP knowledge enables service users and commissioners to make an informed choice of aids which will provide the greatest functional support and access to social and daily activities making best use of NHS/local authority/personal funds

 

Accountability and patients

Being accountable for commissioning quality and budgets, consortia will need the specialist knowledge of a wide range of healthcare professionals.  AHP knowledge will enable commissioning to extend beyond a disease-based model to one that integrates social and educational methods with bio-medical interventions.  This will deliver economies of scale by ensuring that services are embedded in social and community settings, close to home and as a part of daily living, thus improving patient and family experience and avoiding unnecessary admission to hospital.

 

Commissioning processes and teams will benefit from the specialist skills that AHPs bring to maximise patient participation in the commissioning process to improve the accountability of the commissioning process to patients.  AHPS also offer specialist knowledge to evaluate proposed pathways/models of care for the maximum participation of patients/service users in the delivery of their care.

 

 

 

 

 

Education and Training

AHPs have a strong history of delivering interventions through others around the patient by delivering robust training and support.  Their skills in defining the competencies required in the whole workforce and the boundaries between interventions that can be safely delivered by family and community, trained but ‘unqualified staff, and professionally registered staff only will be critical in defining education and training strategies to develop the whole workforce to deliver innovative, integrated services.

 

Advice and leadership

A key benefit of having AHP’s included in the commissioning process is the problem solving nature of their and competencies. They are less likely to instinctively try and reproduce what has been done before, but will look for practical ways to solve real problems within a pathway of care.  Making processes more efficient and using innovative ideas to improve a patient’s function translates well into redesigning patient care pathways.

 

AHPs are experienced in delivering models of intervention that work across organisational and agency boundaries including health, social care, the voluntary and private sector.  They have skills to navigate across boundaries that should be harnessed in pathway redesign.

 

In order to access such intelligence, commissioners will need to be open to questioning assumptions about care pathways; sources of clinical advice and ‘knowing what they don’t know’.

 

 

 

July 19. 2011
Nagendra Kumar Sanath Kumar

Hi dawn Its Quite comprehensive and incorporates our key messages.

Nagen

 

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