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Case Study 9 Patient and Public Involvement - West Norfolk PCT
West Norfolk Primary Care Trust is committed to involving people who use services, patients, carers their families and local voluntary and community organisations in the planning and decision-making process around all the services we provide and commission. Achieving effective Public Involvement in Commissioning is a challenge we have risen to. We started in June 2003 and this case study will take you through the trials and tribulations of setting up the process and, hopefully, making it happen.
Below we set our key documents along the road. By sharing our learning, we hope you can avoid our mistakes and use our successes to inform the development of your own work.
| Patient and Public Involvement (PPI) in Commissioning |
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The new West Norfolk PCT Commissioning Process |
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Terms of Reference (word document) - document to be posted shortly |
The Planning Group consider their role and draft Terms of Reference |
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NEW 3rd Commissioning Process Project meeting 22.06.04 (word document) |
Update on how the 3 arms of commissioning are developing, progress on independent observers and Chair via the Patient and Public Involvement Forums and how this will all be administrated |
| NEW PPI in Commissioning Presentation (PowerPoint document) |
A brief presentation for lay people on the new commissioning process and how patient and public involvement must be embedded into any proposals and how the public will be equal partners in deciding which services are commissioned in future. |
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2nd Commissioning Process Project meeting 21.05.04 (word document) |
Consideration of how the 3 arms of commissioning – modernisation, clinical and public – will deal with the commissioning proposals and how it can be done in a transparent and open fashion. Consideration of ‘Independent Observers’ and an ‘Independent Chair’ for the scoring sessions. |
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NEW 4th Planning Meeting 21.06.04 (word document) |
A change of name from Citizen’s Jury to ‘Public Voice’ – Your NHS, Your Money, YOU help decide! The first few members are recruited. |
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7th April 2004 Board Paper (word document) |
Board paper presented by the Director of Public Health giving an update on progress |
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3rd Planning Meeting 28.05.04 (word document) |
The group decide the title ‘Citizen’s Jury’ doesn’t explain what the public will do. Concerns are aired on ensuring all agencies are signed up to helping support this process |
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Commissioning Proposal submission form (word document) |
The draft proposal form that all ‘proposers’ will need to complete as part of the new commissioning process |
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2nd Planning Meeting 22.04.04 (word document) |
The group decide on the ‘make-up’ of the Citizen’s Jury, broadly representative of the population of West Norfolk |
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Toolkit (pdf document) |
Commissioning Health Services in
West Norfolk Primary Care Trust - A tool for evidence based and cost effective commissioning |
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1st Planning Meeting 10.12.03 (word document) |
The Inaugural meeting of a new planning group to discuss how to tackle PPI in commissioning – setting up a Citizen’s Jury |
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1st Commissioning Process Project meeting 22.12.03 (word document) |
Agreement that the new commissioning process should not just be ‘clinical’ but whole systems and a look at how this might work |
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Board Paper (word document) |
A paper to the Board outlining plans for patient and public involvement in commissioning. |
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Workshop (word document) |
The Report of a ‘Whole Systems Commissioning Workshop’ held on 15.10.03 – looking at a new process for commissioning in West Norfolk |
Introduction
West Norfolk PCT has been involved in an ongoing development programme, supported by the Strategic Health Authority, which is aimed at improving both the commissioning process within local health economies and assisting PCTs to develop a local strategy. The purpose of this work is to enable the PCT to become more proactive in the commissioning process.
West Norfolk Primary Care Trust (PCT) was established on 1st October 2000. The PCT brings together for the first time, responsibilities for the health of the local population and the commissioning responsibilities for healthcare services for the local population.
As a commissioner of healthcare, the PCT is responsible for the purchase of most healthcare services for local people. This involves agreeing the range of health services to be purchased from a healthcare provider (such as a GP Practice; a clinic; a hospital or a specialist centre) for an agreed sum of money. This includes services delivered at local practices, clinics and hospitals; other services within Norfolk and from specialist centres further afield, for example at Papworth, Addenbrookes and London.
This new role requires a new and much stronger partnership with local patients and communities; statutory partners, community and charitable organisations, in order to tackle the underlying health issues facing communities in the West Norfolk area.
West Norfolk PCT has been involved in an ongoing development programme, supported by the Strategic Health Authority, which is aimed at improving both the commissioning process within local health economies and assisting PCTs to develop a local strategy. The purpose of this work is to enable the PCT to become more proactive in the commissioning process. To enable this to happen, the PCT must develop a clear, articulated vision which covers the next 5 - 10 years. Whilst the vision can be imaginative and innovative, it should also include and reference the following points which will help gain the commitment of local partners:
- Targets, both existing and yet to be defined, are givens
- Areas dealing with access, deprivation and regeneration must be acknowledged
- The final document must be explicit about those things the PCT is not going to do
- If there are areas which could provide some quick wins these should be highlighted
- Initially focus each year on three priorities that are reinforced at every opportunity.
The Strategic Health Authority expects each PCT to demonstrate through its commissioning process certain competencies. These include:
- The engagement of Chief Executives in the commissioning process
- Communication between organisations needs to improve and be explicit
- Evidence of clinical involvement and details of strategies to deal with 'gaming' where it occurs
- An understanding of whole system commissioning and evidence of it in use
- A clear understanding of financial flows
- An ability to design and deliver a strategic process which is disciplined and underpinned with value systems
- Processes must be output driven not input driven
Section 11 of the Health and Social Care Act 2001 places a duty on Primary Care Trusts and NHS trusts to make arrangements to involve and consult patients and the public in:
- The on-going planning of services they are responsible for, not just when a major change is proposed
- Developing and considering proposals for changes in the way those services are provided
- Decisions to be made that affect how those services operate.
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