Background
ICSs will be taking on majority of specialised commissioning from NHS England which is also referred to as ‘specialised services delegation’. For our geography, this will be happening from April 2025. Previous commissioning framework was overcentralised, does not reflect the needs of neurological patients and has been a barrier to change. Specialist services need to be more equitably accessible, closer to home, and only in specialist centres where appropriate. Service planning needs to seamlessly connect tertiary, secondary, primary and community care to deliver better patient experience and more efficient care.
As a network, we wanted to use this change in the commissioning framework to:
- Test opportunities for transformation and financial model for delegating specialised commissioning
- Demonstrate improved access, outcomes and experience for patients
Our pilot, which was initiated in Summer 2022, is a 2-year pilot testing the opportunities for more integrated care and better patient outcomes through bringing together the planning (and funding) of both “CCG” and specialised commissioning.
Transformation aims
The pilot adopted a principles-based approach to ensure that:
We took a system-wide approach to delivery:
- High-quality data is collected and analysed to optimise performance and reduce health inequalities.
- Financial benefits and risks and shared proportionally between Trusts.
- Strategic aims focused on the needs of patients and the wider health system.
Case for change
We carried out a detailed population health and clinical service profile focusing on 5 condition groups.
To see our case for change data in greater detail, please click here.
We then took the data we collated to both the South West London and Surrey Heartlands ICS’s executive board to make the case for why neurology should be a system focus for transformation. We wanted the ICSs to invest in the pilot roles and work collaboratively as a network. Neurology networks are not nationally funded – we wanted our network and subspecialty networks to be both service development/transformation networks as well as MDT discussion networks, with multidisciplinary leadership.
System-wide pilot roles
The network is supported to deliver the transformation pilot through investment in 7 system-wide pilot roles to deliver:
- Complex case management and care coordination
- MDT facilitation
- Network support
Pilot role impact
We are beginning to evaluate the impact the above pilot roles are having in relation to improved patient experience, increasing capacity, providing better value for money and ensuring equity of access to specialist services across SWL & Surrey.
For more information
If you work in the NHS and want more information on our transformation pilot, you can sign up to the National Neurology Service Transformation Programme NHS Futures site here.
If you are a clinician working in SWL or Surrey, please find more information on how to refer your patients to any of the above pilot roles here.
If you want to speak to someone from the network team about the pilot, please contact us here.