30th September 2014 Written by James Stephens

James Stephens, Senior Consultant, Skills for Health, reflects on the latest challenges facing commissioners:

The pressures facing Clinical Commissioning Groups (CCGs) are well documented – with a rising expectation across the healthcare sector to deliver more, improve quality and efficiency and achieve better value for money. All this, whilst managing change and concentrating multimillion pound budgets to meet patient needs.
CCGs have an extremely crucial role in the health care system, with the decisions made having a huge impact on the availability and quality of services for patients. However, as is well known, this role is only in its infancy and many CCGs are understandably just finding their way in terms of their responsibilities.

CCGs need support in key areas

Image: James Stephens, Senior Consultant.While it is clear that CCGs have the insight, knowledge and capabilities to perform this pivotal role, it is also evident that greater practical support and guidance will be of real benefit given this enormous responsibility.   From our experience at Skills for Health, there are two key areas in which commissioners could be supported; firstly as commissioners of healthcare services and secondly as employers, helping to develop an organisation and ensure best practice.

Commissioning challenges

Looking at the current commissioning landscape, there are huge challenges to be met. These include very strict budget constraints, increasing patient demand for services, which results in increased pressure on services and the changing nature of the population (e.g. an ageing population, with more complex conditions).   As CCGs are responsible for ensuring that services are of the very best quality to meet the needs of the local community, it is a tough time to be in the decision-making driving seat.

Given the pressures that exist in the health sector, commissioners need to look quite radically at how services are delivered and, in some instances, question how things have been done in the past. One of the main ways in which Skills for Health can work with CCGs is as a “critical friend” to help facilitate and give advice on pathway redesign and service change ensuring commissioned services are as effective as possible and support workforce development.

Working together to achieve best practice

CCGs are also employers in their own right and it’s important that they have the workforce structure and skills in place to deliver high quality services for the local community.  Supporting CCGs is an increasing area of our work, and one in which we feel we can make a real impact. For example, the South East London Commissioning Strategy Programme Office recently brought on board Skills for Health to introduce a Healthcare Assistant (HCA) package that would standardise skills, training and knowledge across six boroughs.  With capacity in general practice such a critical issue, highly trained HCAs are perfectly positioned to play a crucial role in supporting practice nurses.  However, current HCA training and development within general practice is not standardised or regulated – and no minimum standards of HCA skills or training exist on a national or local level – resulting in huge variations in the knowledge and work employees are able to carry out.

To address these issues across South East London, Skills for Health provided an assessment of the current HCA landscape and training needs analysis, a standardised role description, minimum standards and a training specification.

As a result of this review, consultation and analysis, the South East London Commissioning Strategy Programme Office is in the process of taking Skills for Health’s training specification and putting it into an invitation tender – which could allow them to start HCA training as early as this autumn.

To download a copy of Skills for Health new brochure “Patient Centred Integrated Care” designed to outline how it can support CCGs.  To read more about the South East London Commissioning Strategy Programme Office project, click here.