Commissioning for standards
The inquiry concluded that commissioners should have been more effective in commissioning for quality services.
Commissioners need to:
- involve patients, the public and professionals in their commissioning activity
- monitor contracts better in order to drive improvements in quality
- take a stronger role in identifying the delivery of poor services and imposing sanctions on providers
The inquiry recommended that the principle focus of commissioners should be on ensuring that patients are safeguarded through the maintenance of fundamental and quality standards. Commissioners should also require delivery of services against enhanced standards to promote quality, and should intervene when a service is substandard or unsafe.
The NHS Standard Contract, NHS England’s assurance of clinical commissioning groups, and the development of commissioning support services, together provide a new infrastructure to ensure that commissioners have the capacity and capability to scrutinise providers’ services.
NHS England is undertaking a review of incentives, rewards and sanctions through the use of the NHS Standard Contract.
NHS England and clinical commissioning groups are also developing a Framework for Commissiong for Quality which will set out the steps that commissioners should take to assure themselves, and their patients, that the services they are commissioning are safe, clinically effective and result in a positive experience for patients.
Recommendation 123General Practitioners undertaking a monitoring role
Recommendation 124Commissioners applying fundamental safety and quality standard
Recommendation 125Compliance with enhanced standards
Recommendation 126Code of practice for managing organisational transitions
Recommendation 127Commissioners scrutinising providers
Recommendation 128Commissioner access to experience and resources
Recommendation 129Commissioning focus on standards
Recommendation 130Commissioners requirements of providers
Recommendation 131Alternative sources of provision
Recommendation 132Commissioners monitoring contract performance