COMMISSIONING
The development of Clinical Commissioning Groups, as part of the coalition government’s NHS reforms, provides both an opportunity and a challenge to GPs, says Martin Roots, managing director of The Thinking People Group.
T
he opportunities for GPs that arise out of the development of Clinical Commissioning Groups include: • Being in control of the majority of NHS resources and thereby extending their responsibility for the care of their patients;
• The movement of the commissioning of healthcare from a general management exercise in financial assurance to a health assurance tool driven by clinical need;
• The ability to show that, as generalist clinicians, they understand the needs of their patients and can commission care to meet their needs more efficiently than PCTs, can make better decisions and can manage the local healthcare system more effectively.
These opportunities cannot be ignored and we believe that, if it can be done safely, they should be grabbed.
Clinicians need to recognise, however, why these groups are being formed and why they are being offered so much power. They need to recognise that they are evolving in the face of an economic cold climate, a per- fect storm of economic and demographic forces and in the eye of a politically-driven imperative to transform the NHS from a paternalistic parent / child model, where patients are the passive recipients of what the system offers, to an NHS which is driv- en by GPs as the agents of the citizen.
The transition from a general manage- ment-led system to a clinically-led one, to improve clinical efficiency and through that to improve quality and outcomes for patients and value for the taxpayer, is not going to be easy, however.
New leadership and operational skills are going to have to be developed, new organi- sational models will need to be explored, and new partnerships will be required throughout the local health economy, to make this transformation a success – and all this needs to be done quickly and in such a way that ensures sustainability be- yond the authorisation process, timetabled between April 2012 and 2013.
One way to plan and deliver such a 26 | national health executive Jul/Aug 11
transformation is to map a programme of activities onto a ‘maturity model’ such as The Thinking People’s CCG Commissioning Capability Maturity Model.
Such models should incorporate existing national and regional leadership and development programmes with local diagnostics and transition plans, and all these should feed into a programme of work that is designed and delivered by clinically and operationally-experienced consultants and facilitators in conjunction with their own locality subject matter experts: at the end of the day they must own this programme, transformation is only successful if it is not done to you but by you.
In addition to leadership development, specific strategic, managerial and opera- tional models will need to be explored in depth; tools and techniques will need to be embedded and deployed, and specific out- puts (such as constitutions, policies, proce- dures, stakeholder management & commu- nication plans, clinical pathway designs, financial management dashboards, etc) will need to be developed and delivered, in- tegrally to each respective module, as part of a tailored programme for each CCG ac- cording to their current level of ‘maturity’.
The phases of delivery could be broken down as depicted in the diagram above and presented to one Strategic Health
Authority. The desired outcome of such programmes is to have a number of authorised CCGs by April 2012 equipped with the skills and stakeholder networks necessary to begin to work ‘in shadow’ whilst building organisations capable of taking on fully authorised commissioning responsibility by April 2013.
Boards, leaders, and individuals should be supported by a combination of knowledge transfer, coaching, mentoring, guidance and support available when they need it, framed in a language that they understand, and relevant to their stage of development.
The support available from The Thinking People Group, which blends clinical with ac- ademic and experienced programme man- agement and business change expertise, is designed by experienced healthcare profes- sionals and supports a clinically-directed programme to help CCGs deliver their vision – to meet the challenge, grasp the opportunity and dem- onstrate that they de- serve the confidence of every citizen.
Martin Roots
FOR MORE INFORMATION For a no-obligation, no-nonsense discussion with one of the Thinking People’s Team, contact Group Managing Director Martin Roots. E:
martin@thethinkingpeople.com
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