This document provides an update about health reform which focuses on the commissioning of NHS services, and, in particular, hospital services. It sets out an NHS Commissioning Framework which is designed to deliver improved health outcomes and secure best value for money and improved financial health for the NHS, and which outlines key changes intended to strengthen PCT commissioning and drive this reform.

Increasing choice for patients and ensuring greater responsiveness to needs

PCTs will be expected to produce an annual prospectus aimed at patients, the wider public and potential providers, which signals the strategic direction for local services. The prospectus will go beyond any document currently produced by PCTs, setting out the results of local health needs assessments and patient ratings of services, and stimulating service development and opportunities to potential providers by presenting commissioning priorities and areas for future investment.

PCTs will be responsible for the roll out of practice-based commissioning which is intended to provide front line clinicians with the resources and support to become more involved in commissioning decisions, and thereby empower them to tailor services to the needs of their local community.

Securing access to a comprehensive range of services

PCTs will be encouraged to offer new incentives to providers, enabling them to establish new services as well as improve the quality and effectiveness of existing services, including:

• Offering minimum income 'guarantees' within the contracts.
• Supplementing the tariff to make the rewards higher for providers and making capital investment easier.
• Offering bonuses to high-performing local services in the future.

Whilst this will allow greater local flexibility in procuring services, PCTs will face new challenges in balancing the ability to offer incentives to new providers to establish themselves or enter the market with the need to offer a level playing field to competing potential providers.

Achieving best value within the resources provided

PCTs will be expected to critically analyse their local data on referral rates, admission rates and other intervention rates, to see where they stand in relation to the national average and to start developing more evidence-based approaches to hospital-based treatment, which above all take into account the outcomes for patients.

For further information, visit:
Health Reform in England

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