Engage communities and politicians early in resourcing decisions, CCGs told

28 Sep 16

Clinical commissioning groups in the NHS have been offered guidance to help them make difficult resourcing decisions.

A framework, published by NHS Clinical Commissioners, sets out factors that can enable CCGs to command the confidence of the public, patients, local politicians and other key stakeholders when making changes.

It is intended to support CCGs at a time of significant change within the health service that, according to a statement, “makes potentially hard choices increasingly inevitable”.

Making Difficult Decisions: Commissioning Healthcare in times of change, contains tips and guidance based on academic research and insights from interviews with commissioners, patient groups and NHS England. It was produced in collaboration with the University of Birmingham.

Among the tips are for CCGs to plan change management process in advance, and to base decision-making on robust data, where available.

It also advises CCGs to manage stakeholder perceptions through engagement, and through nurturing trustworthy relationships. Support from the local community, clinicians and politicians is vital, the framework notes, recommending that these interests are engaged at an early stage.

Amanda Doyle, NHS Clinical Commissioners co-chair and chief clinical officer at NHS Blackpool CCG, highlighted the challenge that comes from allocating ever-dwindling resources: “Clinical commissioners have always had to make tough decisions and prioritise how finite resources are allocated while maintaining a fair and accessible healthcare system,” she said.

Increasing financial pressures in the NHS, spiraling demand and a drive toward sustainability is making this harder than ever, she added.

“This new report draws on research and the practical experience of commissioners to bring together the factors that can enable difficult decisions to be made and seen through while commanding confidence of patients and the public.”

Difficult decisions could include the potential closure or relocation of entire services such as an A&E department, a maternity clinic or a community hospital. According to one contributor to the guidelines, “NHS staff sometimes forget that the public have strong emotional ties to hospitals” and this would continue “regardless of whether the place can actually deliver safe services.”

NHS Clinical Commissioners co-chair, Graham Jackson, who also chairs NHS Aylesury Vale CCG, acknowledged the public concern that went along with changes to services and systems people normally rely on. 

The public was also increasingly wary of cost-cutting initiatives, which receive a high level of media coverage, he said, confirming that CCGs need to actively engage with all the stakeholders early in the process.

“It is often the case that change is necessary to deliver a better service, rather than just being synonymous with cuts… we need to make sure that our reasons for seeking to do things differently are fully understood by all,” he said.

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