Commissioning for specific diseases or conditions

Information resources to support commissioning for specific diseases and conditions, plus case studies that illustrate how health libraries support work in this area.

Tips on searching the web:

  • Use language, jargon and abbreviations which you might expect to find in trust and government documents to focus your search more effectively, e.g. “Everyone Counts” , “Putting patients first”, “Living well for longer”, “outcomes strategy”, “outcomes framework”.
  • When searching for information on diseases and conditions, try using the phrase ‘people with…’ e.g. ‘people with diabetes’ rather than just ‘diabetes’ as this can reflect the way conditions are described in NHS papers.
  • To limit to NHS papers, try combining your results with: (ccg OR nhs). To look for CCG publications add the following to your google search:  site: ccg.nhs.uk (note the space before the CCG.)
  • You can search for terms such as ‘board paper’ / ‘strategy’  to help to locate Trust papers

Also have a look at our summary of tips on searching the web.


List of contents

General

PrescQIPP
PrescQIPP is an NHS funded not-for-profit organisation that supports quality, optimised prescribing for patients. It publishes evidence-based resources and tools for primary care commissioners, and a platform to share innovation across the NHS. Includes a number of Webkits – collections of resources around a range of topics including Care Homes, Polypharmacy & deprescribing, transfer of care and self care. Free registration open to NHS organisations (incl CCGs and CSUs).

NICE Quality Standards – “a clear description of what a high-quality service looks like so organisations can improve quality and achieve excellence. They should support benchmarking of current performance against evidence-based measures of best practice to identify priorities for improvement.” Each standard brings together guidelines, support for commissioners, audit tools, and information for patients.  The first place to look for evidence to support service development, but many are still under development.

UK Screening portal Quality Assurance the commissioning framework around screening including KPIs and service specifications

Blood disorders

Investing in Health in North Yorkshire and York – Blood disordersNorth Yorkshire and York Primary Care Trust has published a series of short reports suggesting improvements that might be made for each step of a patients’ journey in 23 programme areas.

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Cancers and tumours

Key organisations:

  • National Cancer Intelligence Network – a UK-wide initiative, working to drive improvements in standards of cancer care and clinical outcomes by improving and using the information collected about cancer patients for analysis, publication and research. Includes the cancer e-atlas, commissioning tools, audits, patient experience and other information tools.

Key policies:

Key guidelines:

Key data sources:

  • Cancer Dashboard (NHS England and Public Health England)
    The cancer dashboard is intended as a tool to help clinical leaders, commissioners and providers to benchmark their results against other CCGs and identify priority areas for improvement. Cancers included a breast, colorectal, lung and prostate.

  • Local Cancer Intelligence is a collaboration between Macmillan Cancer Research and NCIN, and it presents the local cancer picture for each CCG through headline information on numbers, needs and experiences. It includes Prevalence, Incidence, Mortality, Survival, Patient experience,Routes to and from diagnosis. An overview about cancer statistics, including information on the latest statistics publicly available and where to find them was published in July 2015.
  • National Cancer Intelligence Network – a UK-wide initiative, working to drive improvements in standards of cancer care and clinical outcomes by improving and using the information collected about cancer patients for analysis, publication and research.
  • Cancer Information ToolsSome tools compiled by the National Cancer Intelligence Network, including mortality, GP practice profiles, equalities portal, e-altases and prevalence. 
  • Cancer e-atlas – Basic information on incidence, mortality and survival for the main types of cancers in males and females. View by Local Authority, PCT or cancer network. 
  • Cancer Commissioning Toolkit – A set of comparative data based resources for commissioners of cancer services which is provided by the National Cancer Intelligence Network (NCIN). Public and Member access
  • HSCIC topic page on Cancer – including new diagnoses and cancer survival data by CCG.

Case studies/ service specs / workstreams/ commissioning tools:

  • NHS Cancer improvement A workstream of NHS Improvement working with and through clinical networks and NHS Organisations across England to transform, deliver and build sustainable improvements across the entire pathway of cancer care. The aim is to make significant improvements by streamlining and redesigning the way that cancer care is delivered to patients to improve the patient experience and support the delivery of the Cancer Outcomes Strategy (2011).
  • Investing in Health in North Yorkshire and York – Cancers and tumoursNorth Yorkshire and York Primary Care Trust has published a series of short reports suggesting improvements that might be made for each step of a patients’ journey in 23 programme areas.
  • Cancer Commissioning ToolkitA range of high-level indicators, as well as a number of links to more detailed information, right across the patient’s journey: from prevention and screening through referral and treatment to living with and beyond cancer, as well as end of life care. Public access includes service specifications and data) and Authorised access.
  • Transforming Cancer Care – new approach to cancer and end of life care services by four CCGs in Staffordshire and Stoke on Trent. using a two-stage, ten-year contract.  Stage 1 (up to two years) requires a prime provider/service integrator to manage the contracts for all the services along existing cancer care pathways. Stage 2 the provider will assume responsibility for managing the provision of cancer care. See tender document here.

Cardiovascular problems

Key organisations/websites:

Key policies:

Key guidelines:

Key data sources:

Case studies/ service specs / workstreams/ commissioning tools:

  • UCL Partners – part of the Academic Health Science Networks (AHSNs) are working to design and deliver an integrated cardiovascular system, with workstreams in place to research Enhanced Early Stroke Discharge, Atrial Fibrillation, Familial Hypercholesterolemia, and there are downloadable documents on their cardiovascular clinical proposals

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Dental problems

Dental Health
Resources from the North West Public Health Observatory – the lead PHO for dental health.

Investing in Health in North Yorkshire and York – Dental problems
North Yorkshire and York Primary Care Trust has published a series of short reports suggesting improvements that might be made for each step of a patients’ journey in 23 programme areas.

Endocrine, nutritional and metabolic problems

Key organisations/websites:

  • National Diabetes Information Service (NDIS) NDIS signposts to a comprehensive range of diabetes data, tools and information via one web portal and includes resources from the Yorkshire and Humber Public Health Observatory (now Public Health England) , NHS Information Centre, Diabetes UK and NHS Diabetes. The tools and reports are also arranged by question such as what is the quality and cost of diabtetes care.
  • Food and healthResources from the East Midlands Public Health Observatory the lead PHO for food and health.
  • ObesityResources from the South East Public Health Observatory the lead PHO for obesity.

Key policies:

Key guidelines:

Key data sources

HQIP Diabetes audits (Adult and children) – data and benchmarking on complications, mrortality and health checks. Useful for QIPP schemes to assess impact of NICE guidelines.

Diabetes Longer Lives (PHE Fingertips resource) – Data by CCG on prevalence and other indicators.

Case studies/ service specs / workstreams/ commissioning tools:

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Eye and vision problems

Key organisations:

Royal College of Ophthalmologists – Commissioning Ophthalmology Services

Key policies:

  • England Vision Strategy –  (part of UK Vision Strategy) working to promote the importance of maintaining good eye health, and making available resources and tools including guidance on local planning, JSNA and local commissioning.

Key guidelines:

Key data sources

Case studies/ service specs / workstreams/ commissioning tools:

  • Commissioning toolkit for community based eye care services. This document provides PCTs and practice based commissioners with practical advice on commissioning community based eye care services. It draws on evidence that has emerged from the evaluated pilot pathways (glaucoma; age-related macular degeneration (AMD); low vision) that were set up following the work of the Eye Care Services Steering Group.

Gastro intestinal and liver problems

Investing in Health in North Yorkshire and York – Gastrointestinal system problems January 2008
North Yorkshire and York Primary Care Trust has published a series of short reports suggesting improvements that might be made for each step of a patients’ journey in 23 programme areas.

IBD Standards
A collaborative of UK organisations to ensure high quality standards for IBS – including standards for services and resources for commissioners and services, IT and audit and evidence.

Liver disease profiles (One of the PHE fingertips series)
PHE Profiles of liver disease across local authorities. The page includes links to other key resources around liver disease.

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Health and wellbeing

Business Case for Prevention
The costs of preventable ill health are significant. Islington PCT library helped Public Health strategists research where investment is most likely to reduce health inequalities and yield a good return. These programmes were approved and monies allocated. This example is taken from LondonLibraries Alignment Toolkit.

Hearing problems

Audiology Improvement Programme
NHS  Improvement pilots around audiology services. Now archived.

Action Plan on Hearing Loss (NHS England, DH 23 March 2015)
Adult hearing services guidance (National Community Hearing Association August 2015)

Infectious diseases

NHS immunisation statistics, England
Statistics on uptake of childhood vaccination, BCG, HPV and influenza vaccinations.

Learning disability problems – see People with Learning Disabilities

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Long term conditions (including End of Life Care and Telehealth/Telecare)

Reading list:

Future Fit – Detailed references and further reading about long term conditions and frailty to support the acute service review across Shrewsbury and Shropshire.

Improving care for long term conditions a Kings Fund reading List

Key organisations/websites:

  • NHS Networks – Long Term Conditions Information, support, access to best practice examples and supporting policy to those who are involved or interested in development of GP commissioning for LTCs.
  • Person-centred care resource centre (Health Foundation) – a resource centre designed to help healthcare professionals implement a more person-centred healthcare service, where people are supported to more effectively manage and make informed decisions about their own health and care. The resource centre currently focuses– supporting people to more effectively manage (SMS) and make informed decision (SDM) about their care.
  • National End of Life Care Intelligence Network – a PHE network which aims to improve the collection and analysis of information related to the quality, volume and costs of care provided by the NHS, social services and the third sector to adults approaching the end of life.
  • Coalition for Collaborative Care : Action for Long term Conditions – brings together people, including people with long-term conditions, and organisations from across the health, social care and voluntary sectors
  • Ambitions for Palliative and End of Life Care: A national framework for local action 2015-2020 “A knowledge hub where you can find resources, such as assessment tools, useful information, best practice examples and case studies, that will help you implement the Ambitions framework.” Many of the resources have been transferred from the NHS IQ and the End of Life Care Facilitators’ Network websites.

Key policies:

Key guidelines: – see guidelines for individual conditions

Key data sources:

LTC Dashboard – Part of the House of Care model  – A summary of metrics that will support intelligent commissioning for long term conditions across health and social care across five areas; risk factors, prevalence, quality of care, quality of life and economic activity.

National End of Life Intelligence network – collection and analysis of information related to the quality, volume and costs of care provided by the NHS, social services and the third sector to adults approaching the end of life.

Telehealth/Telecare

  • Designing successful telehealth interventions. An NIHR-funded realist review (2015) to help commissioners understand better how telehealth might work, in what circumstances and for whom.
  • Technology Enabled Care Services (TECS) – a collection of resources from NHS England, Includes a Telemedicine Evidence collection (December 2014), a case study database, strategic planning, procurement, implementation, measurement & evaluation and improvement resources as well as Resource for Commissioners (Commissioning Assembly January 2015) which aims to help commissioners to identify practical tools that can help maximise the value of technology enabled care services for patients, carers, commissioners and the whole health economy. Also includes the 3millionlives archive.
  • House of Commons POST Note on Telehealth/Telecare (Feb 2014) which describes currentUK nitiatives and the role they may play in delivering future care.
  • Ready Steady Go Toolkit: Telehealth Implementation Toolkit, CLAHRC 2013. A structured approach to deliver the business objectives of telehealth.
  • Qualitative evaluation of the Yorkshire and the Humber Telehealth Hub by 2020health, 2013. “The aim for the Hub was to support care closer to home and deliver services to 2,100 patients.” BUT see “CCG axes telehealth service” in E Health insider September 2013.
  • Telecare and Telehealth – a game changer for health and social care a report from Deloitte UK Centre for Health Solutions (2012) provides a synopsis of the available evidence on the costs and benefits of telecare and telehealth. It is based on literature reviews, case examples, discussion with key stakeholders and our experience in working with technology companies and health and social care providers in the UK and other countries.
  • Pulse Commissioning Topics – Long Term Conditions and Telehealth news and articles. RSS feeds available.
  • Kings Fund Health Topic  – Telecare and telehealth – a collection of resources including the Whole System Demonstrator, in particular the KF Reading Room resources.
  • Telehealth / telecare / telemonitoring resources to support patients with LTCs from the Yorkshire & Humber HIEC
  • Whole Systems Demonstrator telehealth trials – find a full list of publications here and a paper from PSSRU outlining the approach to calculating the costs here.

Case studies/ service specs / workstreams/ commissioning tools:

Dementia

Dementia Gateway from SCIE

Dementia Evidence Toolkit – This toolkit was developed as part of the MODEM (Modelling the Outcome and Cost Impacts of Interventions for Dementia) project. It includes two resources:

Dementia Challenge a DH website brigning together the work on the National Dementia Strategy including an Interactive map shows quality of dementia care across England.

Dementia quality standard
A description of the markers of high-quality, cost-effective patient care, covering the treatment and prevention of dementia. The standards used by the NHS Outcomes Framework to measure the quality of services.

Dementia Partnership
A resource for those working to improve outcomes for people living with dementia, sponsored by the Strategic Clinical Networks for Mental Health, Dementia and Neurological Conditions South West. Includes a Dementia Prevalence calculator and commissioning tools.

Dementia: Statistics on prevalence and an outline of the Government’s work to improve diagnosis, care and research 2015. (House of Commons Briefing papers SN07007, 23 February 2015) This note outlines Government, NHS and other statutory bodies’ work to improve dementia diagnosis, care and support and research. It also includes statistics, tables and maps on age-adjusted dementia prevalence across the UK, including for each English Parliamentary constituency.

Dementia and housing: An assessment tool for local commissioning a self-assessment tool by Housing LIN which focuses on local commissioning processes and decision-making. The tool combines all available assets and resources to create the conditions that reduce the risk of developing dementia, and to develop a framework of support to help those with dementia, their families and carers, to have as good a quality of life as possible.

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Mental health problems

Key organisations/websites:

Joint Commissioning Panel for Mental Health (JCPMH) is co-chaired by the Royal College of Psychiatrists and the Royal College of General Practitioners. It is a collaboration between seventeen leading organisations, inspiring commissioners to improve mental health and wellbeing, using a values based commissioning model. JCPMH produces guidance on mental health services in all settings and for all populations, including BME, CAHMS, forensic, perinatal and public health.

Emotional wellbeing is sponsored by the National Clinical Director of Mental Health and aims to bring together information about emotional well-being, mental health issues and learning disability. It has a really useful Resources page (including a page on commissioning mental health services)  and document library including toolkits and care pathways.

MIND “advice and support to empower anyone experiencing a mental health problem. We campaign to improve services, raise awareness and promote understanding.”

NHS Confederation Mental Health Network –the voice for NHS funded mental health and learning disability service providers in England.” Useful briefings and commentary on policy documents.

Royal College of Psychiatrists – Mental Health Toolkit – resources for healthcare professionals to reference regarding the diagnosis and treatment of mental health problems and Including Background and Information for Commissioners.

Also the RCPsych College Centre for Quality Improvement (CCQI) which “aims to raise the standard of care that people with emotional or mental health needs receive by helping providers, users and commissioners of services assess and increase the quality of care they provide.”

Mental Health Partnerships  a specialist knowledge portal, bringing together Networks, organisations, groups and individuals to share knowledge and learning to improve services and the mental health and wellbeing of communities.

Key policies:

Key guidelines:

Mental health and behavioural conditions – NICE guidelines (Dont forget the Quality Standards)

Key data sources:

  • HSCIC Mental health  – statistical returns on mental including the Mental Health Minimum Data Set (MHMDS) – trust-level breakdowns for the national statistics. See also Mental Health Minimum Data Set Online which provides trust-level breakdowns for the national statistics presented in the Bulletin shown as graphics with year on year comparisons.
  • Investment in mental health in working age adults and older adults (DH) . A finance mapping exercise. Data for 2011/2012 and links to previous years here. Discontinued 2012/13.
  • Key facts and trends in mental health An NHS Confederation briefing which includes key trends in morbidity and behaviour,

Case studies/ service specs / workstreams/ commissioning tools:

CAMHS (Child and Adolescent Mental Health Services)

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Musculoskeletal Disorders

British Orthopaedic Association Commissioning Guidance collection – Including online Commissioning Dashboards and Procedures Explorer Tools for each of the surgical procedures covered. Each Dashboard shows indicators for activity commissioned by CCGs for the relevant surgical pathway and provide an indication of the quality of care provided to patients based on metrics such as length of stay and readmission rates. Guides include Low Back Pain, Painful Deformed Great Toe in Adults, Painful Tingling Fingers, Pain Arising from the Hip in Adults, Painful Osteoarthritis of the Knee, Subacromial Shoulder Pain.

Fractures – datasets:

  • Hospital Episode Statistics, Admitted Patient Care – see HSCIC
  • Accident and Emergency Attendances in England  – see HSCIC

Neurological system problems

Epilepsy Commissioning Toolkit (Epilepsy Action and Epilepsy Society)  – a single access point of resources to support effective commissioning for children and adults with epilepsy

Compendium of Neurology Data, England – 2012-13 (HSCIC, March 2014) – a compendium of the accessible Neurology data from various data sources.

Neurological Commissioning Support
A joint initiative of the MND Association, MS Society and Parkinson’s UK to work with PCTs and County Councils to  to deliver better outcomes for services in neurology. A Neuronavigator website is under development to provide easy access to the information needed to plan effective neurology services. (Registration required – Launch date February 2011)

National Pain Audit Final report 2010-12
Audit report of pain services across England and Wales – recommendations include access, staff skill mix, competencies, case mix, outcomes data and relevant standards documents.

Five integral steps to support commissioning headache services
An HSJ article (Jan 2012) presenting the case for intermittent care headache clinics led by a GP with a special interest in headache.

Action on Neurology – Improving Neurology Services (Modernisation Agency, 2005)
Reports of a step by step process involving scoping issues, identifying potential good practice, and testing and developing good practice through pilot sites.

Better Value, Better Care – Your Guide to Commissioning in Epilepsy – part of Epilepsy: A resource for primary care from Epilepsy Action

Quality Standards:  Care of Adults with Acquired Brain Injury, July 2014, West Midlands Quality Review Service. Please note the copyright statement on page 2. (See also Quality Standards for NICE guidance)

See the Info.Point briefing compiled by Library & Knowledge Services South Tyneside NHS Foundation Trust on Neurological Disability.

Respiratory problems

Key organisations:

Key policies:

Key guidelines:

Key data sources:

  • INHALE  a new Interactive Health Atlas for Lung Conditions in England to help clinical commissioners assess the impact of respiratory disease on local populations, assess variation and identify the services required to meet those needs.

Case studies/ service specs / workstreams/ commissioning tools:

  • Respiratory Futures – a collaborative website including a Knowledge Portal which includes commissioning tools, guidelines etc on respiratory topics, including COPD and directory of organisations working across the respiratory and healthcare sectors.
  • British Lung Foundation COPD patient pathway, (Nov 2013)  to help people living with COPD, their carers and healthcare professionals identify the type of care COPD patients should be receiving, from diagnosis onwards.

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Skin problems

Commissioning Dermatology – British Association of Dermatologists 2011

Dermatology guidance for GPs with special interests
(GPwSIs) revised 2011- guidance for commissioners in respect of the development of community cancer clinicians and skin surgery services.

Primary Care Dermatology Society – Includes a collection of guidelines for specific conditions with discussion of who should manage patients (primary or acute care) and resources around GPwSI and service development/ commissioning of dermatology services.

Social Care Needs

Social Care Institute for Excellence (SCIE) “improves the lives of people who use care services by sharing knowledge about what works. We gather and analyse knowledge about what works and translate that knowledge into practical resources, learning materials and services including training and consultancy.” Resources, briefings and tools to support commissioning across social care

Trauma and injury

InjuriesResources from the South West Public Health Observatory the lead PHO for injuries. In particular the England Injury Information Resources Guide to online statistics, databases, websites, strategies, polices and reviews that may be relevant to work supporting injury prevention in England.

Women’s health and sexual health

HIV, sexual and reproductive health current issues bulletin issue 3: commissioning HIV services.(February 2014) This bulletin has been developed by Public Health England and the Department of Health, with input from and the support of the Local Government Association, the Association of Directors of Public Health and the English HIV and Sexual Health Commissioners Group and outlines key responsibilities and how they have changed.

Commissioning regional and local sexual health services – A collection of guidance and resources for commissioners of HIV, sexual and reproductive health services: includes an outline of responsibilities for sexual health services, prevention, treatment, information, data sources, advice and support from PHE.

Maternity Knowledge Hub on the Child and maternal health Intelligence Network (formerly Chimat)

Service Standards for Sexual and Reproductive Healthcare March 2012, Faculty of Sexual & Reproductive Healthcare, RCOG. Includes workload, training, service provision, patient involvement

Provision of community gynaecology services – Memroandum of Informaiton NHS Enfield (Nov 2010). Includes outcomes, critical success factors, procurement process.

See also examples of search strategies:

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Comments

Commissioning for specific diseases or conditions — 2 Comments

  1. Hi
    Just to let you know that as well as the BOA commissioning guides we have 27 guides on a wide range of surgical areas that have been developed through a NICE accredited process. We also have linked HES based data tools freely available linked with these guides.
    If you would like to add something about these other resources I would be happy to send you the links.
    Regards
    Emma Fernandez

    • Hi Emma
      Many thanks for this. It would be really useful if you could put together some up to date text(and links) about MSK resources for commissioners which I could add to the Handbook.

      regards
      Anne Gray
      anne.gray5@nhs.net

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