A new approach to priority setting has been developed and tested which supports World Class Commissioning competencies 3 and 6.
The Health Foundation has supported a team of London School of Economics (LSE) researchers to work with NHS Isle of Wight in developing a new rigorous approach for setting commissioning priorities. The approach incorporates engagement with stakeholders and technical value for money analysis. This allows commissioners to take account of a number of different factors and pressures when making decisions about which areas of healthcare to focus on.
The new approach supports World Class Commissioning. It supports both competency 3, which is about engaging patients and the public, and competency 6, which requires commissioners to prioritise investment according to local need, service requirements and NHS values. Now, more than ever, commissioners need to prioritise to make the most of increasingly strained funding. Decisions over the allocation of resources will need to be made in evidence based, transparent and systematic ways to ensure that they are sound, fair and strategic.The approach was recognised at the South Central Regional Health and Social Care Awards where the joint team received the Excellence in Commissioning Award.
The approach
The LSE team worked with NHS Isle of Wight whilst they were developing their strategic plan. The objective is to reduce mortality on the island from a number of diseases and conditions, including cardiovascular disease, respiratory disease, and improving the health and well being of children.
A hundred stakeholders including patients, clinicians and the local council participated in day long workshops. Each workshop examined a health priority area and participants used multiple criteria analysis to generate their top three interventions.
The LSE research team then estimated value for money and population health gain for each intervention (e.g. psychological therapy, prison mental health and dementia services). The findings were presented to the PCT board which used this evidence as the basis for determining local investment in health services.
The results
Innovative services were developed and the whole community was engaged in prioritising interventions and understanding which would deliver the greatest health benefit.
Dr Jenifer Smith, Director of Public Health and Isle of Wight Chief Medical Advisor said: “As a result of the project, one of the service design changes taken forward for people with respiratory disease has already seen emergency asthma admissions on the Island fall by 50 per cent. I hope this gives confidence to Islanders that we are commissioning services on their behalf to a very high standard.”
What next?
The Health
Foundation is now supporting the roll out of variations on this approach at NHS
Sheffield and NHS Buckingham. A
collaborative of South Central PCTs and their local providers have approached
the team to work on a similar project in 2010.
The Department of Health has been working with the LSE to incorporate
the model in the new mental health strategy, New Horizons.
