Department of Health, Social Services & Public Safety (DHSSPS)
Tuesday, 14 July, 2015

Response submitted on behalf of the Federation of of the Royal Colleges of Physicians of the United Kingdom.

You may be aware that in January the previous Minister for Health, Social Services and Public Safety announced a review of the arrangements for commissioning health and social care services in Northern Ireland. The terms of reference for the review are attached.

A small project team, led by DHSSPS but with representation from the Health and Social Care Board and Public Health Agency, has been established and work is underway to produce a final report by August 2015.

Commissioning in this context refers to the process by which the health and care needs of a population are assessed, and services are planned and purchased to meet these needs and improve health and wellbeing. In undertaking the review, it will be essential that we have input from as wide a range of stakeholders as possible to inform our understanding of the strengths and weaknesses of the current system as well as possible options for improvement.  Input from clinicians will be critical in understanding the strengths and weaknesses of the current commissioning system.

I would therefore welcome short written submissions (up to a maximum of four sides of A4 paper) to the review for consideration by the project team, and should therefore be grateful if you would circulate this letter, together with the terms of reference, to your members.

Terms of Reference

To ensure that the commissioning of health and social care services is fit for purpose to meet the changing and growing needs of the citizens of Northern Ireland into the future, the Department has instigated a review of commissioning to identify opportunities for improvement.

This review will:

1. Undertake an assessment of how the commissioning process facilitates the delivery of high quality and efficient health and social care services in Northern Ireland, with particular reference to:

  • Assessing the health and social wellbeing needs of the population of Northern Ireland.
  • Strategic planning to prioritise needs within available resources, including the use of financial and other levers, to reshape services to meet future needs.
  • Engaging patients, users, carers / families and other key stakeholders at a local level in the commissioning of health and social care services.
  • Securing, procuring, incentivising and agreeing high quality, value for money service provision to meet the assessed and prioritised needs of the population.
  • Ensuring the delivery and outcomes from services commissioned.
  • Evaluating impact of health and social care services and feeding back into the commissioning process in terms of how needs have changed.

2. Bring forward recommended options to improve the effectiveness of the delivery of health and social care services in Northern Ireland.

It is expected that the review will report in the summer of 2015.

Federation of the Royal Colleges of Physicians of the United Kingdom

Review of Health and Social Care Commissioning Arrangements in Northern Ireland

This response is provided by the Federation of the Royal Colleges of Physicians of the United Kingdom (Royal College of Physicians of Edinburgh, Royal College of Physicians of London and the Royal College of Physicians and Surgeons of Glasgow).

The Federation is pleased to respond to the Department of Health, Social Services & Public Safety (DHSSPS)’s call for views on a review of Health and Social Care Commissioning Arrangements in Northern Ireland.

General comments

The Federation takes the view that healthcare commissioning within Northern Ireland should be streamlined, and made more efficient and responsive to healthcare needs. There should be greater utilisation of expert clinical opinion within the system, making use of the specialist views and experience of clinicians across the care sectors, and improved transparency to increase confidence in the process.

We would urge caution in moving to a tariff based system, which may be expensive to implement for a small population such as that of Northern Ireland.  There is a view by some senior physicians that there should be no separate commissioning body (such as the current HSCB), but that Trusts should provide funded services according to local need, with a strategic overview coming from the DHSSPS to avoid duplication of services by Trusts.