Commissioning levers

There are a number of levers that can support the commissioning of shared decision making and self-management support.  For example:

Establish the national standard but allow innovation:

  • NHS Standard Contract (particulars and general clauses).
  • Primary care contracts.
  • Tariff business rules.
  • NICE Quality Standards.

Measure, baseline and publish data

  • Quality Accounts
  • Care Data
  • Quality Standard Indicators

Implement well designed incentives

  • CQUIN – for example, Islington CCG have an Integrated Care CQIN with a self-care component
  • NHS Standard Contract   (Local incentives)
  • Quality and Outcomes Framework – for example in 2013/14 South Tyneside CCG used the Quality and Productivity element of QOF indicators, applied to secondary care outpatient referrals (Q&P 1-3)
  • Enhanced Service – for example, Islington CCG have incentivised GPs by providing funding for longer consultations for care planning

Maintain improvement and set the new norm:

  • NHS Standard Contract (National sanctions)
  • NHS Standard Contract   (Local sanctions)
  • Primary care   contracts
  • National and local sanctions

QUESTION:  What commissioning levers have you used or might you use locally?

  • Do you have any examples that we could use?

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