This is the ultimate weblog in our sexual health commissioning blog series, specializing in the final two levels of the commissioning cycle: ‘doing’ and ‘reviewing’.
Stage 3: Doing – Procuring a service or intervention
The ‘doing’ stage of the commissioning cycle is commonly about tendering for and procuring a service or intervention from a supply associate.
I intentionally use the time period ‘partner’ right here, as I’ve all the time thought-about efficient commissioning to be about partnerships, and robust relationships between companions who’ve the shared purpose of improved health outcomes for the inhabitants.
Procurement is an space of technical experience for which we should search recommendation from inside our personal organisations. This weblog covers options, which under no circumstances exchange the knowledgeable opinion you’ll obtain out of your procurement colleagues.
Prior to going out to procurement, you could want to undertake market engagement actions. This helps commissioners in creating one of the best specification potential for the native inhabitants, and can curiosity suppliers within the tender.
Procurement colleagues will present recommendation on completely different contracting fashions and fee mechanisms. If you’re a part of a wider accountable or built-in care system or devolved administration, the contracting preparations could also be pre-determined. It is necessary to contemplate the implications for sexual health, in addition to what suits your native circumstances greatest.
The contracting mannequin may have implications for features of the service reminiscent of information submissions, scientific governance and coaching. With a chief contractor mannequin, the prime contractor will often be chargeable for guaranteeing necessary information necessities (GUMCAD, CTAD, HIV surveillance, SRHAD) are fulfilled, and for coaching and clinical governance of sub-contracted companies.
Talking to others who’ve been by an identical course of and studying from them is without doubt one of the most respected issues we are able to do. In recognition of this, PHE is working with the English Sexual Health Commissioners Group, to supply a searchable useful resource of sexual health tendering experiences from throughout the nation. This will help you discover a related instance and contact a colleague to search out out extra.
Stage 4: Reviewing service and intervention success
The evaluation stage of the commissioning cycle covers numerous completely different actions, from exploring whether or not the service is doing what you requested; to understanding whether or not interventions are having the specified impact; and figuring out whether or not the companies and interventions are nonetheless related in your inhabitants.
KPIs, audits and service consumer suggestions
Identifying whether or not the service is doing what you requested it to do pertains to contract administration processes and measurement towards key efficiency indicators (KPIs).
The nationwide service specification template consists of advised KPIs. It’s necessary to not overburden suppliers by requiring them to report towards numerous KPIs, however deal with the necessary measures. Agreeing a typical set of KPIs with others that fee the identical supplier will cut back the burden on the supplier, and enable for comparisons.
There might also be different information that you just and the supplier comply with evaluation recurrently to tell broader conversations about high quality, rising wants, or how native provision must adapt and change.
Agreeing a programme of audits together with your service supplier can be necessary, taking account of nationwide programmes organised by BASHH, BHIVA, FSRH and the NCSP, and the programme of audits that the supplier organisation has deliberate. Discussion of the outcomes of audits will inform plans for service enhancements, and re-audit – the final stage of the audit cycle – permits us to see if the modifications which were applied have had the specified impact.
In addition to plain contract monitoring conferences, it’s worthwhile for commissioners and suppliers to fulfill recurrently to evaluation accessible information on each course of and end result measures. This sort of stocktake can take a sector led improvement method. An instance of this method that has been very effectively obtained just lately is the chlamydia care pathway workshops that enable all native stakeholders to deal with guaranteeing the pathway is delivered as successfully and effectively as potential.
PHE is eager to assist commissioners and suppliers to establish the ‘best way’ to realize a desired end result. Evaluating interventions is a key software to see the influence of the modifications made regionally, and add to the proof base that others can draw on.
To this finish, PHE is creating a set of analysis assets for sexual health, reproductive health and HIV, together with an introductory information, workbook, and menu of output and end result measures. These assets will probably be revealed within the subsequent few months.
Reviewing inhabitants want
The closing a part of the evaluation stage brings us again full circle to ‘analyse’, as it’s about reviewing inhabitants want to make sure that the companies and interventions that had been related are nonetheless related given modifications in inhabitants or epidemiology.
Commissioning is a steady cycle of assessing inhabitants want, and designing interventions to enhance outcomes. It requires robust partnerships throughout the programs between commissioners, suppliers and the general public who’re all seeking to obtain the identical factor – bettering affected person and inhabitants outcomes as effectively and successfully as potential.
Read our first two blogs on sexual health commissioning right here: