Value based commissioning
Haringey CCG has been working to put outcomes at the heart of how we commission services through an approach called ‘value based commissioning’.
Value based commissioning will enable us to make significant improvements in patient care and in the way that services work together to meet patients’ needs. As commissioners, we will use a contractual mechanism that supports the integration of services and allows us to pay providers for how well they manage to achieve the outcomes that have been defined by patients.
To begin with, we are using this approach for two population groups: older people with frailty in Haringey, and people with diabetes across both Haringey and Islington.
We began, in November 2013, to work with patients and frontline staff to establish which outcomes of care would make most sense to measure. We worked with experts to identify a methodology for measuring these outcomes, many of which relate to people’s experience and their level of independence. We worked with clinicians to plan what service delivery model would be most likely to deliver these outcomes. We established a baseline cost so that we know how much we currently spend on healthcare for these population groups. We have also worked on building a contractual methodology that will allow us to build shared incentives on achieving outcomes of care.
This year (2015-16), we will begin to measure outcomes of care. We will move towards the creation of single budgets for care of these population cohorts (encompassing our current spend across our acute and community health providers for these population groups). We will be appointing Lead Providers to drive forward the provision of care for people with diabetes and people with frailty, working across organisations. We will start to embed shared financial incentives to improve outcomes into our contracts so that we are providing incentives to focus on achieving improvements in outcomes.
If this approach is successful, we will use it more widely for other population groups.