Customer turned commissioner

A study from the Joseph Rowntree Foundation looks at recent evidence of involving older people in commissioning health and social care. There's particular focus on the experience of programmes in Salford and Dorset. The Royal Pharmaceutical Society has published a discussion paper on involvement, shared decision making and medicines, highlighting the gap between the rhetoric and the present reality. Meanwhile, the Health Foundation has launched a self management resource support centre, offering an introduction to the theory behind and evidence for self care. A study in Journal of Public Health assesses the merits of using discrete choice experiements to incorporate public views into healthcare priority setting.

Patients, consumers or guinea pigs?

The need for effective public engagement is never more pressing than in this chilly economic climate, argues thinktank Involve. The NHS Confederation offers some advice to CCGs on how to make this work in the new commissioning landscape. Pressure Group the Patients Association has also done some research on the matter and amongst its concerns is how to reward and support patient representatives in CCGs. Elsewhere, the announcement that the government wants to foster innovation by releasing NHS patient data to researchers has not played brilliantly. Some have pointed out that the proposal to make every NHS patient "a research patient" does not sit particularly well with the patient empowerment agenda.

Joined up thinking

The need to integrate adult social care and health care is made from an economic viewpoint by the Audit Commission in a briefing and accompanying benchmarking tool. A systematic review of integrated working between health services and care homes finds a rather limited field of evidence, with integration happening mostly at patient level and very much health service led. Trafford PCT's faltering efforts to develop integrated care are analysed in a report from the Nuffield Trust. A batch of articles from the journal of integrated care examine inclusion of people with sight loss, a pilot in Norfolk addressing teenage pregnancy rates and the various models of integration used in Devon. RCGP offers guidance on commissioning integrated urgent and emergency care.

Commissioning round-up

A resource pack from Liverpool PCT points the way to effective commissioning for outcomes in health and social care, surveying appropriate use of a variety of models in programme planning and delivery. Thinktank Reform has published papers from their recent conference An NHS for patients: making commissioning work. The NHS Alliance's Nurses in Commissioning network considers the case for involving nurses in commissioning. Also from the NHS Alliance, a paper looking at commissioning urgent care and the scope for integration.

Clash of the Titans

GP Online offers a useful summary of current guidance for GP commissioners on conflicts of interest. The Health and Social Care Bill makes it clear that CCGs must deal effectively with conflicts of interest, but so far, no guidance has been forthcoming from DH. This article summarises that provided by RCGP and BMA. RCGP has also produced guidance on ethical issues in commissioning.

To strategically go

Strategic commissioning is being embraced by local authorities as the way forward for public service delivery, according to a report from local government think tank Localis (in partnership with Essex County Council and Mears). Commission Impossible draws on findings from a survey of council leaders and chief executives which shows that the practice of commissioning services from outside providers is widespread and "set to accelerate significantly." While various healthcare press reports focus on the make-up of newly formed clinical commissioning groups (CCGs), a paper from the NHS Confederation and Royal College of General Practitioners addresses the oft-raised question of conflicts of interest and offers some timely guidance. In an article for Pulse, the chair of the Tower Hamlets CCG summarises this group's approach to integrated commissioning, joining the dots between primary and secondary care and local authority provision. This month's expert on call from the NHS Institute features Mark Jennings, Senior Advisor to the Development for Commissioners Programme, focusing on integration and commissioning.

Integrate!

A quick summary of what integrated care could mean for the NHS has been published by the King's Fund. It summarises an earlier report by King's Fund Chief Executive Chris Ham. The Royal College of General Practitioners (RCGP) is seeking the collective wisdom of its membership on the matter of integration. In a consultation paper published last month, the College asks about system design, payment systems and effects on GP practice boundaries, amongst other issues. Responses are due in by 31 October 2011. Meanwhile a paper from the Nuffield Trust looks at the contribution commissioners can make in promoting integration.

Breathless

Around one in four people are “likely to be diagnosed and receive medical attention for COPD during their lifetime” according to a recent Canadian study published in the Lancet, which compares lifetime risk for COPD with that for other chronic diseases. Another study published in BMC Public Health takes an international perspective on assessing impact of COPD in the working age population. While there’s general agreement that this condition presents a huge challenge to health services, there’s less agreement on approaches. With the recent publication of an outcomes strategy (for COPD and asthma) and quality standards, DH has taken a stand. Current spending is mapped by Dr Foster for Pulse, revealing the inevitable variations. HSJ reports on GP-commissioned clinics for COPD in Norfolk, designed to promote self-management and reduce hospital admissions. NHS Improvement summarises what has been learned from National Improvement Projects on managing COPD as a long term condition, again focusing on self-management and reducing admissions.