Values-based commissioning of health and social care


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Frequently asked questions

We want to create the right incentives to enable people to remain independent, recover quickly and remain well in mind and body. And to do this, we need to focus on outcomes. As commissioners, we will use a contractual mechanism that supports the integration of services and allows us to pay providers for how well they manage to achieve the outcomes that have been defined by patients.

We are using this new approach to commission for older people with frailty and people with diabetes in the first instance. The aim is to introduce value based commissioning for people with diabetes in Islington and Haringey, and for older people with frailty in Haringey from July There has been lots of engagement over the past 18 months with patients, clinicians, local providers, GPs and other stakeholders to discuss this approach, define outcomes and agree how it could be introduced.

What is social value?

The next step is to talk to different organisations that provide health and social care to our populations at the moment, to see if there are any who would have the willingness, capability and capacity to be able to take a leadership role in re-orienting service provision towards achievement of outcomes for patients across Haringey and Islington. Thank you to everyone who attended our provider information event this morning Friday 20 March.

It provides a skills base and other support processes for working with differences in values held by those engaged in making decisions.

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Shipping costs are based on books weighing 2. If your book order is heavy or oversized, we may contact you to let you know extra shipping is required. Some books may be shipped from India. List this Seller's Books. Payment Methods accepted by seller. Another example is the Friends and Family Test FFT , an important feedback tool that supports the fundamental principle that people who use NHS services should have the opportunity to provide feedback on their experience.

When combined with supplementary follow-up questions, the FFT provides a mechanism to highlight both good and poor patient experience. This kind of feedback is vital in transforming NHS services and supporting patient choice. Value-based pricing, in which the price paid to pharmaceutical companies for drugs is based on evidence of value for patients, as opposed to cost-benefit calculations, could incorporate wider factors such as benefits to society and could improve access and encourage innovation, but more rigorous evaluation is needed [ 21 ].


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Value-based healthcare has the potential to be used in local and national priority setting and policy development. The value should also be considered more broadly than just within healthcare services, encompassing public health and local government to tackle wider determinants of health. According to a recent publication by the Institute of Healthcare Management, system leadership is essential for the survival of the health service [ 22 ].

Similarly, taking steps to define, develop and implement value-based health care could help health systems swim rather than sink and allow them to continue to provide the services upon which millions of citizens depend. A variety of tools has been developed for use in England to help the NHS to deliver value. The NHS RightCare programme aims to offer better value for patients by ensuring they receive the right care at the right time and place, focussing on areas with the greatest opportunity to improve health and make sustainable improvements to reduce unwarranted variation [ 23 ].

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Download e-book Values-Based Commissioning of Health and Social Care (Values-Based Practice)

To ensure patients are placed at the centre of care and able to control their health, we must provide them with the tools in which to do this. This aims to support them in identifying areas of unwarranted variation and areas for improvement with greatest potential for increased value [ 24 ]. Casebooks are also available with examples of best practice to assist CCGs with how to improve value in the areas identified through their value packs. One such casebook gives the example of how data can be mapped to each stage of the diabetes care pathway and used to identify areas of unwarranted variation in outcome, leading to the identification of areas for improvement that may have been missed under traditional methods of monitoring based on process measures [ 25 ].

CCGs are encouraged to compare their outcomes with other areas with similar demographic characteristics and to seek advice from those providing better value for their populations. Such data can be used to improve value for both individual patients and for populations through optimum resource allocation. Local purchasers of care, operate a priority setting process and mechanism to ensure that the limited health care resources are spent in the best possible way to maximize health gain.

We provide three conditions as examples of how the concept of value in health care was considered and adopted.

Integrated commissioning and provision | Local Government Association

We undertook a thorough review of the evidence and found that evidence for the intervention was lacking. We realized the opportunity cost of the intervention and undertook a consensus building exercise with patients, managers, clinicians and the public on the value of patellar resurfacing.


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  • Carpal tunnel decompression rates were significantly higher in one of the local institutions compared to the national and regional rates after standardization. A similar approach was adopted and a detailed pathway and access criteria were developed which reduced the rates to a significant extent. It was apparent that there was overuse of the procedure and the value to patients and the system was being ignored.

    Health and social care commissioning: an exploration of processes, services and outcomes

    Tonsillectomy rates show huge variation across the country and this has also been addressed in a similar manner. Having an open and honest dialogue with both patients and clinicians and their support is essential to promote values-based health care.

    Porter recommends classification of outcomes in three tiers [ 16 ]. The International Consortium for Health Outcomes Measurement ICHOM is a non-profit organization using a theoretical framework developed by Porter and Teisberg [ 26 ] to define global outcome standard sets based on what matters to patients and then driving adoption and reporting of these measures across the world [ 27 ]. Their outcome sets include common diseases, such us cancers and cardiovascular disease and primary and preventative care for older people.

    Values-based commissioning of health and social care Values-based commissioning of health and social care
    Values-based commissioning of health and social care Values-based commissioning of health and social care
    Values-based commissioning of health and social care Values-based commissioning of health and social care
    Values-based commissioning of health and social care Values-based commissioning of health and social care
    Values-based commissioning of health and social care Values-based commissioning of health and social care
    Values-based commissioning of health and social care Values-based commissioning of health and social care
    Values-based commissioning of health and social care Values-based commissioning of health and social care
    Values-based commissioning of health and social care Values-based commissioning of health and social care

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