Dorset Clinical Commissioning Group (CCG) became fully delegated for Primary Care Commissioning from NHS England on 1 April 2016. This means we now hold the finance and decision making responsibilities for the way we plan and buy our GP services. Primary care in this context means general practice and not the other three areas of primary care (Dentistry, Optometry and Pharmacy).
Delegated responsibility for primary care commissioning provides the CCG with the opportunity to have more local decision making, working closely with local partners to further improve out-of-hospital care and making local commissioning decisions based on the best outcomes for patients.
Additional responsibilities include:
Development of clearer, more joined up vision for primary medical care, which is aligned to wider CCG plans for improving health services and care closer to home,
Increased local clinical leadership and public involvement in primary medical care commissioning, enabling more local decision making,
Improved opportunities for GP practices to work together and with wider community teams.
Key areas of work
The Primary Care Commissioning Strategy and the Dorset General Practice Forward View Delivery Plan have been developed to consider how primary care can remain sustainable to provide future services for the population of Dorset. The next stage will see Practices in each Dorset locality working together with local people to develop a plan for what suits their community best. The CCG has a clear engagement structure to support the delivery of this process.
Our Primary Care Commissioning Strategy
We know from our GP survey results that patients are mostly happy with the services they receive but they have told us that there is more work to do, especially around access. We also know from the conversations we have had with our GP Members and their teams that they are under extreme pressure with an increasing workload and diminishing workforce. The CCG has recognised for some time that things need to change; there is now also national recognition via the General Practice Forward View (GPFV). This national guidance and supporting programmes, coupled with our new decision making powers, gives us a fantastic opportunity to address these difficult challenges.
Our reasons for change are simple: General Practice in its current form will find it difficult to survive, if it does not evolve. GPs and their teams have developed and adapted their individual practices well over time resulting in many great achievements; a wider reaching strategy is now required to stretch beyond the boundaries of individual practices and better address the current challenges. As we have recognised in our work for the Clinical Services Review (CSR) and Integrated Community Services (ICS), the existing health system was not designed to meet the needs of the current population. People are living longer, with often multiple long term conditions.
Focusing on individual episodes of disease specific care is not an efficient way for us to be working, nor does it make the best use of the public money we have available to us in Dorset. We want to celebrate the success of General Practice, which has provided real value for money. We also want to acknowledge that General Practice is facing extremely challenging times. By working together, we are confident that we can achieve a strong, sustainable and modernised integrated GP model, which is attractive to work in and where patients can consistently receive the best care, in the most appropriate place. It is our ambition to do this as part of achieving our strategic goal for longer healthier lives via a fully integrated health and social care system by 2020/21.
Update – December 2016
The Primary Care Commissioning Strategy and Plan was submitted to the Primary Care Committee of NHS Dorset CCG.
During December 2016 feedback from Stakeholders was collated and the Strategy which was published on line in January 2017
Phase 2 – November 2016 to March 2017
Our programme of engagement will show how we plan to engage with our GP Members, their teams, patients, carers and the public to inform the development of the models. Part of this process will be to identify whether there is a need to go to formal public consultation. In this case NHS Dorset CCG would provide appropriate support.
NHS Dorset CCG has a defined engagement process, developed in line with national guidance. When reviewing, designing or planning services the CCG routinely undertakes a number of actions to facilitate meaningful engagement, ensuring the views of local people inform every stage of the commissioning cycle.
These include the following:
Seeking local views,
Engagement on proposed changes,
Equality impact assessment process.
The CCG has a clear engagement structure to support the delivery of this process.