Collaborative Commissioning
Context
1.1 National Context
Delivering for Health was the Minister for Health and Community Care's response to " A National Framework for Service Change in the NHS in Scotland: Building a Health Service NHS Fit For the Future". The work undertaken by Professor David Kerr and the SEHD to produce " An NHS fit for the future" was an excellent example of collaborative commissioning. The process provided opportunities for patients, the public, clinicians, public sector and private sector organisations with a role to play in improving health and health services to contribute collectively to a strategy for health in Scotland. It is a testament to the robustness of this collaborative commissioning that both Professor Kerr's report and the Minister for Health and Community Care's response attracted cross party support.
1.2 Local Context
NHS Tayside put in place a Single Delivery Unit in 2006. From its inception it was intended that the delivery unit should be viewed less as a structure but more importantly as a collaborative. It brings clinicians and managers together in order to provide high quality services, which meet the needs of patients in Tayside.
In its first year the Single Delivery Unit has made good progress in breaking down barriers between primary and secondary care. It has enhanced the establishment of CHPs and created a working environment, which is not based on line management but on matrix management. A matrix management approach brings clinicians patients and managers together to work on an agenda around improving services for patients. The organisation creates teams to work together to improve services. This can be for short-term work or sustainable service delivery. Staff members can therefore expect to play a role in a number of teams based on their ability to deliver better outcomes for patients.
The challenge of matrix management is to support managers, clinicians and patients to work together on improvement. This means working in a structure with few reporting lines, lots of scope for innovation but an extremely strong governance structure that challenges and judges on the basis of improved outcomes, quality and value for money.
NHS Tayside has also made progress in expanding its joint working with patients and the public. The Open Space (appreciative inquiry) events held in autumn 2006 and the involvement of patients via managed clinical networks and Patient Public Groups have all contributed to the strength of the patient voice..
The model for improvement provides NHS Tayside with a strong model to drive this agenda forwards to the next stage of its development.
2. Principles and Values
In NHS Tayside our mission is "to continually improve patient care and patient experience through an active and positive collaboration between patients, clinicians, and managers where we work together to solve problems and deliver innovative solutions".
The collaborative commissioning model set out in this paper provides a framework to progress this mission i.e. It describes how patients, clinicians, managers and partners will work together on an ongoing basis to create and agree a common agenda around improving services for patients. This will influence NHS Tayside's Commissioning Plan. NHS Tayside's improvement collaborative work provides us with the tools to deliver our mission i.e. an inclusive methodology for how we will deliver small steps of change, which will deliver the promises, made in the Commissioning Plan.
All participants in the collaborative commissioning process will strive for continuous improvement and aspire to compete with the best in the world. They are driven by a strong evidence base and are willing and able to be held accountable for the continuous improvement of services.
This model requires NHS Tayside to actively seek to strengthen the power of patients in the commissioning model and to continue to engage clinical staff and key partners in this collaborative process. It builds on examples of good practice, which already use the components of the methodology set out in the collaborative commissioning model e.g. The Palliative Care Strategy. The model provides a framework to extend this good practice across all of NHS Tayside's strategic and improvement agenda.