Tuesday, 24 April 2012

Patients Not Organisations

He was an elderly chap who wanted to know more about clinical commissioning. He used services regularly, and valued a particular local service which involved social care, community nurses and traditional medical services.

'So,' he asked, 'What does this mean for me? Will I be able to use my local service?'

The answer is that as a practising GP I'm hopefully close to his needs, and that we are working jointly with local authorities and clinicians to not only sustain but to improve this service.

But is it that simple? As CCGs what will our role be in making these decisions? Well we certainly won't be doing it on our own. We are part of a system. The local authority will oversee public health, for example, which will commission some important services in primary care. Educationalists will oversee training and accreditation, which providers rely upon to maintain rotas. Networks will oversee specialised services. The NHSCB will hold primary care contracts. NICE will issue guidance to which we will be expected to adhere. Monitor will regulate providers and commissioners...The list goes on. Try describing it to patients.

So what is the role of CCGs? It is our responsibility to ensure these organisations work together for the benefit of local patients. To make sure there aren't too many cooks, working in isolation. Decisions made at each level will impact on others. Relationships will be key. Immature organisations will need mature relationships. We have to challenge each other to improve services, remove barriers to change and focus on patients.

We are all accountable to our populations, whatever the scale. I am accountable to my patient who needs his service to function and care for his wife. The challenge is to balance, and appreciate, national and local priorities. Patients have to be central to each, and will align the organisations involved. If we ask how our decisions benefit services at each stage then we will be successful in ensuring we maintain our focus on patients and not organisations. That is how we will be judged.

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