Commissioning of services is a key part of NHS reforms. Although this is by no means a new concept, it has now taken on a greater importance because of the need for the NHS to re-establish financial balance, the pressure to deliver more services outside of the hospital setting and the anticipated role of competitive tendering.
It is proposed that commissioning will be overseen by the new PCTs working in collaboration with practice commissioning groups. The process itself will require a series of steps, including: an assessment of need for a particular service; a specification based on that need and matching the resources available; procurement of the service; and then monitoring of the service as it is delivered. Good quality commissioning ought to include the voice of service users.
While there has been some guidance issued by the Department of Health (DoH), this has not delivered a clear understanding of what is expected. It may eventually be not too dissimilar to the old GP fundholding system, although with larger units of collaborating commissioning practices overseen by the PCTs.
The PCDS, together with organisations including Diabetes UK, the Association of British Clinical Diabetologists and the National Diabetes Support Team have developed a commissioning toolkit for diabetes. The toolkit addresses the key issues that any commissioner will need to consider. Several PCTs have already started to use it to help reconfigure their services. In Leicester, a working group led by the PCT is examining local needs and mapping the sort of service needed by the local health community.
A collaborative pilot scheme of about six PCTs will start in the new year, the group will implement the toolkit with any lessons learned to be disseminated nationally. The toolkit itself can be downloaded from:
www.diabetes.nhs.uk/downloads/commissioning_toolkit_diabetes.pdf (accessed 20.12.2006).
Increasing daily step count reduces mortality and morbidity up to around 10 000 steps, with no minimum step count for benefits.
20 Mar 2023