Effective GP Commissioning - Essential Knowledge, Skills and Attitudes

A Practical Guide

Sunil Gupta

• Publisher: CRC Press
• Year: 2017
• eBook ISBN:
  9781315346205
• Topic: Medicine
• Subtopic: Management

The proposed abolition of Primary Care Trusts and transfer of their commissioning functions to GP consortia have been greeted with intense excitement by some GPs, and with extreme trepidation by others. This book explains what commissioning is and how to do it, enabling clinicians to flourish as commissioners in the new NHS. Some topics that will be familiar to readers, such as long term conditions management, patient safety and the wider determinants of health, are explored here from a commissioning perspective. Others which may be less familiar, such as how to delegate, how to improve productivity, management theories and the content of financial accounts, are explored in detail. Additional skills needed by commissioning GPs - fostering innovation, assertiveness and emotional competence as well as negotiation, presentation and even media management skills - are outlined in a clear and straightforward fashion, while the necessary attitudes involved are described with reference to the Nolan Principles of Public Life. A straightforward yet comprehensive guide, Effective GP Commissioning - Essential Knowledge, Skills and Attitudes will be essential for GPs, prospective GPs, and those with an interest in effective commissioning. 'A useful resource for all GPs whatever their level of engagement and indeed for non-clinicians also. Sunil Gupta is clearly a GP and business magpie who has an incredible ability to gather, organise and present useful information. The content of this book is well-researched linking considerable volumes of information in a very useful, constructive manner.' - From the Foreword by Simon Gregory

PART 1

Commissioning

CHAPTER 1

What is commissioning?

Commissioning is the process of assessing the needs of a local population and putting in place services to meet those needs.

PROCESS OF HEALTHCARE COMMISSIONING

1. Assess the healthcare needs of the local population and review how well existing service provision meets those needs.
2. Identify priorities for investment and design services/identify opportunities to meet the needs.
3. Acquire these services/create opportunities through contracts with a variety of service providers including GPs, NHS trusts, foundation trusts, third sector and independent sector organisations and partnerships with other agencies.
4. Ensure the services are provided effectively, and monitor quality and outcomes.

WHY DO WE NEED COMMISSIONERS?

➤ To act as advocates for patients and improve patient care, patient experience and service responsiveness and performance.

➤ To act as custodians for taxpayers by improving efficiency and value for money.

➤ To ensure NHS planning and provision is needs/demand-led, not supplier-led and to bring about reconfiguration of services by shifting investment.

➤ To improve patient safety.

➤ To improve health outcomes.

THE WORLD CLASS COMMISSIONING PROGRAMME

Launched in December 2007, this programme aimed to drive up the commissioning capability of local NHS commissioners. It introduced 11 organisational competencies that set out the knowledge, skills, behaviours and characteristics commissioners need:

FIGURE 1.1 The commissioning cycle.

1. locally lead the NHS
2. work with community partners
3. engage with public and patients
4. collaborate with clinicians
5. manage knowledge and assess needs
6. prioritise investment
7. stimulate the market
8. promote improvement and innovation
9. secure procurement skills
10. manage the local health system
11. make sound financial investments.

THE APPROACH OF THIS BOOK

I believe that the knowledge, skills and attitudes needed for effective GP commissioning are similar to the competences of World Class Commissioning but not identical. These requirements are covered in Parts 2–4:

Part 2 Knowledge needed for effective GP commissioning

➤ Assessing local health needs.

➤ Budgets.

➤ Business plans.

➤ Change implementation.

➤ Commissioning case checklist.

➤ Decision-making.

➤ Delegation.

➤ Effective use of emails.

➤ Ethics.

➤ Financial accounts.

➤ Integration.

➤ Key Terms.

➤ Long-term conditions management.

➤ Management theories.

➤ Mentoring.

➤ Patient safety.

➤ Public involvement and patient engagement.

➤ Procurement.

➤ Productivity.

➤ Project management.

➤ Quality improvement.

➤ Recruitment.

➤ Teamwork.

➤ Wider determinants of health.

Part 3 Skills needed for effective GP commissioning

➤ Assertiveness.

➤ Avoiding burnout.

➤ Cognitive behavioural therapy skills.

➤ Conflict resolution.

➤ Communication skills.

➤ Consultation skills.

➤ Dealing with difficult colleagues.

➤ Emotional Bank Account.

➤ Emotional competence.

➤ Innovation.

➤ Media skills.

➤ Meetings skills.

➤ Negotiating skills.

➤ People skills.

➤ Planning skills.

➤ Political skills.

➤ Presentational skills.

➤ Stress management.

➤ Time management.

Part 4 Attitudes needed for effective GP commissioning

➤ Adherence to the Nolan Principles of public life (selflessness, integrity, objectivity, accountability, openness, honesty and leadership).

➤ Other attitudes needed for effective GP commissioning (cost-effectiveness, long-term thinking, outcomes not activity, patient focus, pragmatism not ideology, tough love and a commitment to creating win-win situations).

SUMMARY

➤ Healthcare commissioning is the process of assessing the needs of a local population and putting in place services to meet those needs.

➤ A large range of knowledge, skills and attitudes are required to carry out effective healthcare commissioning.

CHAPTER 2

The Medical Leadership Competency Framework

This framework describes the leadership competences that doctors need in order to become more actively involved in the planning, delivery and transformation of health services.

It has been jointly developed by the Academy of Medical Royal Colleges and the NHS Institute for Innovation and Improvement in conjunction with others.

The framework can be used to highlight individual strengths and development areas through self-assessment and structured feedback from colleagues as well as assist with personal development planning and career progression.

The framework is in five parts:

1. Personal Qualities
2. Working with Others
3. Managing Services
4. Improving Services
5. Setting Direction.

PERSONAL QUALITIES

Doctors showing effective leadership need to draw upon their values, strengths and abilities to deliver high standards of care.

This requires doctors to demonstrate competence in:

➤ Self-awareness: being aware of their own values, principles, assumptions, and by being able to learn from experiences.

➤ Self-management: organising and managing themselves while taking account of the needs and priorities of others.

➤ Self-development: learning through participating in continuing professional development and from experience and feedback.

➤ Acting with integrity: behaving in an open and ethical manner.

WORKING WITH OTHERS

Doctors show effective leadership by working with others in teams and networks to deliver and improve services.

This requires doctors to demonstrate competence in:

➤ Developing networks: working in partnership with colleagues within and across systems and improving services.

➤ Building and maintaining relationships: listening, supporting others, gaining trust and showing understanding.

➤ Encouraging contribution: creating an environment where others have the opportunity to contribute.

➤ Working within teams: to deliver and improve services.

MANAGING SERVICES

Doctors showing effective leadership are focused on the success of the organisation(s) in which they work.

This requires doctors to demonstrate competence in:

➤ Planning: actively contributing to plans to achieve service goals.

➤ Managing resources: knowing what resources are available and using their influence to ensure that resources are used efficiently and safely.

➤ Managing people: providing direction, reviewing performance and motivating others.

➤ Managing performance: holding themselves and others accountable for service outcomes.

IMPROVING SERVICES

Doctors showing effective leadership make a real difference to people’s health by delivering high-quality services and by developing improvements to services.

This requires doctors to demonstrate competence in:

➤ Ensuring patient safety: assessing and managing risk to patients associated with service improvement.

➤ Critically evaluating: being abl...

Table of contents

• Cover Page
• Half title
• Title Page
• Copyright Page
• Contents
• Foreword
• Preface
• About the author
• Dedication
• Part 1 Commissioning
• Part 2 Knowledge needed for effective GP commissioning
• Part 3 Skills needed for effective GP commissioning
• Part 4 Attitudes needed for effective GP commissioning
• Conclusion
• Index