Dr Sam Wild


Session ran by Dr Lucy Chiddick, Leeds

May 3rd 2019

This was a morning session with Lucy Chiddick (Health Inequalities lead in Hull CCG). I have found commissioning an intimidating topic which I find difficult to understand. The session was valuable in demystifying this topic and giving practical examples of how new ideas and changes can be made (the example used being the pathways project in Hull)

Below are my notes and key learning points from the session

– Changes in structures common and confusing for everyone! Currently CCGs – commissioning and provider arms (wide spectrum of community services). Regarding commissioning more collaboration (health sector, local authority, mental health), over bigger area, was STPs then healthcare partnerships now ICS (integrated commissioning systems)

– Population health – aim to target services to specific populations

– GP networks developing – practices with similar populations and needs – more likely to know what intervention will help for that population (30 to 50 thousand in total). Mentioned in GP forward view (developing workforce, working at scale, networks). Long term plan pushed forward networks (and now in new GP contract)

– Translating ideas into practice can be tricky

– GP contract/NHS plan; bringing more secondary care into the community (ca, resp, MH, stroke, CHD), workforce and diversifying workforce (inc looking after staff), IT, Indemnity, QOF changing. ??how to measure health inequality

– GPs in CCGs – read papers, advocate (eg for vulnerable groups) – comment on specs for stuff coming in (but ?not really changing or adding new things)

– Working in CCGs – build relationships with people and get people on side. Look everywhere for funding, along with the political climate. Also new roles can be created eg health inequalities lead. Example being pathways and resources and services for homeless people. Homeless strategy 2018 from gov helped as was in political view at that time, persuading people that this was a good idea, putting healthcare for homeless in the housing strategy for the city, need to make business case and finance – ask business analysis people for stats.

– Practicalities of this work – self directed and set own agenda. time management important (freedom to get to meet people and know what is happening). Different work to clinical – goal is long term – changes take long time

– Things to consider, does the PCN need sub-clinical lead eg in health inequality.

How the above has developed my understanding of commissioning – the most important part for me was demystifying this topic – knowing the structures are changing and confusing even to those involved makes it less intimidating – it would take time for anyone to understand when working in these roles. The change to Primary care networks is something I had heard about, but it is more clear now.

This has given me more confidence on how I could be involved if an opportunity came up to have some involvement (before I would feel under-qualified and intimidated by this area, but I do have experience and skills coming from my practice and also the teaching I have been having on Fridays)

Dr Sam Wild