Question Time

How will we judge the success of Clinical Commissioning?  Well, it depends who's doing the judging.  From a patient's perspective, we will be judged by our level of engagement and actions in areas that matter to the local population.  Engagement is meaningless without actions, and actions are pointless if they do not improve outcomes or matter to patients.

So do we know what local priorities are?  We are likely to know from a financial perspective - we can all name areas of 'risk'.  They are often contractual. We are likely to know from a quality point of view, or waiting time perspective.  These are regularly monitored.  But what matters to patients?  I don't claim to know all the answers - but it is important we find out.

Locally, we have consulted with patients, stakeholder groups and clinicans regarding our commissioning intentions and strategic plan.  It was extremely valuable, but was led by planning timescales and will be much improved next year.  These processes need to be ongoing, not based around deadlines for plans. 

I recently attended a local 'Question Time' panel, organised by Links.  It was a joint event with local councillors, social care leaders and community and secondary care providers.  What did I learn? 

First, the clear priorities were the same as those evident from consultation.  They centred on dementia care, care homes and services for those with learning disabilities.  Increasing problems, led by changes in life expectancy and the need to improve quality for those in need of long term care.  Second, these were questions I couldn't answer on my own.  The issues raised included social care, council services, home provision and healthcare.  The obvious benefit of answering these questions jointly highlights the need to improve the services themselves jointly.  Patients usually don't have one illness,  they don't need just one service, they need joint working around their needs. 

So how will we be judged by patients?  I hope we will repeat the panel next year, and will be able to describe how we engaged with patients to improve these services, what actions were taken together and how outcomes are improving.  Then we will have improved the system.