Health Matters | Paul Corrigan's blog

Meeting for the Smith Institute

Off to the seaside to talk at a fringe meeting at Labour Party Conference. For those who have never been to political party conferences it is not the main set pieces in the Conference that are the main attraction but the fringe meetings. Hundreds and hundreds of meetings packed into lunchtimes, breakfasts and early evenings.  At the beginning of the week people usually fill their diaries with events they want to go and then spend all their time rushing between them.
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But first…

World class decommissioning an explanation of why it is so important.

Using the phrase world class decommissioning on my blog has started to alarm some people. It’s as if I am saying that the whole of a PCTs job is decommissioning. That’s not the case; the organisation s will go on buying new things and hopefully will do so in a way that increasingly approaches worldclassness.
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What are the parameters of world class decommissioning?

If world class commissioning consists in part of PCTs commissioning services that provide very good health and health care outcomes and doing it really well, then world class decommissioning involves stopping the provision of services that are less than optimal in health care outcomes or value for money and doing this very well.
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Why World class decommissioning is more important than world class commissioning

On September 16^th the DH launched the second year of the World Class Commissioning Process. This is an important step forward in a number of ways.

• First, this is the first time the DH has recognised that improvement assurance systems require, if they are to really create improvement, needs iteration. It has to happen in a similar way every year so that people are not just randomly examined, but improve on an annual basis.
• Second, they have recognised that whilst the assurance process is very similar to last year with the same rhythm to the process, there are some stark differences to the development of a five year plan in the autumn of 2009 from the autumn of 2008 and these all concern the relationship between resource and outcomes. The same resource will have to buy much better outcomes.

So the process starts with a clear definition of what commissioning is all about.  
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This, the second week in September 2009, has given us greater clarity about the resources that will be available to the NHS over the next few years whoever wins the next general election. There are two sets of milestones that will make this clearer and more specific, but the direction from both political parties is clear.
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The story in the Health Service Journal and several of today’s newspapers is typical (to join the historical analogy of the month) of the phoney war of 70 years ago on the French and Belgian borders.  As a story it is phoney because McKinseys have been recommending that the NHS should have 10% less staff for about the last 5 years. So the fact they think this is hardly news. And the political reactions to it are part of a phoney war,  Government :- How dare they say NHS funding will be need to be cut Conservatives:-  We believe in greater efficiency but – even though it’s two thirds of the costs- this will not touch a hair on the head of front line staff.
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