Somerset could be amongst the first areas in the country to create fully integrated health and social care services following a decision by the GP led body that plans and funds the county’s health services.
At their monthly meeting today (16 July), members of Somerset Clinical Commissioning Group (CCG) discussed a proposal in principle to collaborate with Somerset County Council and considered an outline business plan that could lead to an entirely new system of service funding to be adopted in the future known as ‘Outcome Based Commissioning’.
This is a radically different approach to the funding of services and is designed to get the best value out of the health and care system in Somerset over the coming years.
Such a system could see Somerset County Council and Somerset CCG pooling their respective health and social care budgets in a way that would not only incentivise patients’ health and social care needs to be delivered in a comprehensively joined up way, but also place an emphasis upon the county’s providers of hospital and community health services to focus upon helping patients improve their physical and mental health, rather than treating people after they become ill.
With rising levels of preventable ill health associated with obesity, poor diet and lack of exercise, an enhanced focus upon prevention is essential in the future. It would embrace social service teams and encourage greater engagement of voluntary and community organisations.
Speaking to CCG Governing Body members, Chairman, Dr Matthew Dolman explained that the year-on-year rise in demand for health and social care services from a rapidly growing elderly population, combined with the need to find over £200 million pound efficiency savings over the next five years, meant that ‘doing nothing’ was not an option.
Local research indicated that 5% Somerset patients (27,000 people) currently accounted for almost 50% of the county’s £1 billion pound health and care budget.
If Somerset County Council and the CCG were to adopt an ‘Outcome Based Commissioning’ model of service it would require a number of changes by both organisations.
This would include greater emphasis upon reducing the level of preventable ill health in the community, placing a greater emphasis upon integrating services through closer collaboration and better co-ordination of care for patients as they move through the health and social care systems.
Dr Matthew Dolman told CCG Governing Body members: “These are significant proposals and ones that are absolutely necessary for future delivery of health and social care in the county. Joining up fragmented systems to deliver high quality care is imperative; we need a system that can deliver high quality care that is affordable.”
Dr Dolman went onto to explain that an ‘Outcome Based Commissioning’ model stood to provide patients with a better, more joined up experience of health and social care, but success was linked to the need for the county’s hospital and community health service Trusts to work effectively together in the re-allocation of resources and agreement with regard to the extent to which services would be joined up.
CCG Governing Body members aopproved, in principle, the following recommendations set out in the outline business case.
- To approve in principle to move to an ‘Outcome Based Commissioning’ model of commissioning health and social care
- To work with NHS England to see how local GPs might develop detailed options for their practices to be a part of an ‘Outcome Based Commissioning’ model of service
- To agree for the senior leadership of the Somerset CCG to work closely with Somerset County Council and NHS England on closer integration of health and social care services, including discussions regarding pooled budgets. (Subject to proposals being reviewed and agreed at a future meeting)
- To support the development of a full business case in collaboration with Somerset County Council and NHS England (To be brought to a future meeting of the CCG Governing Body)
Copies of the outline business case for developing an ‘Outcome Based Commissioning’ model of health and social care in Somerset is available from the Somerset CCG web site: www.somersetccg.nhs.uk/about-us/governing-body/meetings-and-papers/governing-body-agenda-and-papers-16-july-2015/