Health care commissioning has begun to establish itself in a new form in England and through the structure of Clinical Commissioning Groups is aimed at purchasing health services. CCG's are tasked with challenging services to radically improve the outcomes of health care at a population level, and this dramatic change in focus demands a strategic commitment to innovation and improvement across the health care system and a shift in emphasis along the clinical pathway towards primary and secondary prevention. This is nowhere more evident than in the management of long-term conditions, where patients in primary care have complex and sometimes unmet needs that lead to unnecessary hospital admissions and unscheduled care.
The Intelligent Commissioning Theme began in 2008 and initially offered a structured learning set programme for five or more commissioning teams drawn from PCTs and Practice based commissioning consortia across South Yorkshire. Each team will work closely with a research theme within the CLAHRC to produce a research based commissioning specification for the future provision of services for people with COPD, Stroke, CHD, Depression and Diabetes. When in 2010 there was a radical re-organisation of health care commissioning and a high level of turbulence in the commissioning workforce the theme closed and was re-designed to provide a more bespoke level of knowledge exchange.
The Innovation in Commissioning Theme was re-launched in March 2011 and recruited 6 projects that sought to re-design services against the backdrop of a critical strategic priority for the commissioning organisation. In all cases the goal remained the improvement in the quality of services, more efficient use of resources, improvements in access to services, improvements in health, reduction in health inequalities, and financial balance. Working with 6 clinical/service managers and commissioner, the Innovation in Commissioning Theme has incorporated expert advice from the South Yorkshire CLAHRC in relation to health economics, knowledge translation and process and systems re-design using whole systems methodologies.
In addition to the proactive use of knowledge and leadership facilitation in the CLAHRC, the theme has included some evaluation of existing and innovative services which have been re-designed to improve patient outcomes and make productivity gains. The learning from these projects has been included in the work of the theme and shared across all projects.