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Commissioners will expect the new provider to add value. This might be, for example, by creating pathways to reduce waiting times and hospital stays, improving patient and clinical outcomes or integrating with existing local services. They will require clearly defined reporting processes.

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Commissioners imageExperience and research with commissioners highlighted some key assurances they would expect from the new provider:

  • How patient outcomes will be improved is paramount.
  • How will shared expertise work?
  • When services are being provided over a bigger geographical area, they will want to see that they support and are integrated with existing local services.
  • They will want to see that due diligence is done thoroughly for proposed new sites and that an organisation can provide an effective service when geographically distant from the centre.
  • Additional costs or financial efficiencies will need to be clearly evidenced and justified.
  • Commissioners will be concerned if a network appears to create a monopoly in an area – which can create a bigger problem if the provider fails –  so any proposal needs to address this risk.
  • They will expect the new provider to bring innovation to the service.
  • Commissioners may expect to have a single lead commissioner across the entire network with clearly-defined responsibilities and reporting arrangements able to hold the provider to account across all its sites.
  • A networked care model across a wide geographical area is likely to have implications for the lead commissioner who has a duty to visit all sites. This needs to be considered in planning.
  • There will need to be standardisation of care but also flexibility to develop local bespoke pathways where needed – not just one way of doing things.
  • Clinical leadership will be seen as important. Involving local GPs in delivering the services should be considered.

Top tips when drawing up a case for the commissioners:
  • The host trust should engage its local commissioner at an early stage when considering bringing a specialist provider to ensure the sustainability of an existing service.
  • The host trust will need to ensure that the new provider understands both the host and provider commissioners’ needs, challenges and priorities.
  • Look at the relevant CCG’s stated intentions, performance against measures of public health outcomes and its financial situation, for example the actual spend per weighted population compared to the allocated spend.
  • Ensure commissioners are behind you and try to identify what they want from the service – will that work for you?
  • Commissioners should understand the implications of adopting a new model, which may include an increase in the number of patients attending the service.

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