The landscape of the NHS has seen major changes over the past five years. The commissioning of services has been radically altered with the creation of local Clinical Commissioning Groups (CCGs), which have unprecedented power to set their own priorities and greater control over their budgets than the Primary Care Trusts that preceded them. Now, with the devolution of the entire health budget to Greater Manchester from this year and other devolution pilot areas planned from 2017, it seems likely that even more spending power is likely to rest at the local level in future.
Alongside these changes, the NHS faces formidable challenges ranging from an ageing and increasingly chronically ill population to financial pressure on key services to low staff morale (as evidenced by this week’s junior doctor’s strike). It is crucial that charities are able to rise to meet the needs of healthcare professionals and their patients, as external providers are increasingly relied upon to support healthcare delivery. From our research, we know that some health professionals with CCG/CSU roles prefer to commission charities due to their non-profit nature. This presents opportunities for charities working in the sector to offer health professionals critical support with patients and services. In order to do so, it is vital that charities understand how to communicate their expertise to health professionals.
So what are professionals with CCG roles’ key priorities when commissioning services? And on the ground, what are GPs and nurses priorities when referring individual patients? These are some of the questions we ask 150 GPs (including 75 with CSU/CCG roles) and 100 nurses in the Primary Healthcare Monitor, our annual survey of health professionals.
In 2015, we found that the top priorities for professionals with CCG roles when commissioning services were, by some margin, cost-effectiveness and quality provision of services. Both were selected by just over half of GPs with CCG roles as a key priority, while timely delivery and good patient outcomes also ranked highly. Less important were the demand from patients and recommendations from other health professionals.
In terms of patient referral, healthcare professionals’ priorities focus on three key areas: meeting the individual needs of the patient, timely delivery and a local presence. Ease of access to information and organisational credibility also featured highly, while range of services, national scope and previous patient experience came in as less important.
That’s a lot of information to take in, but it reveals some vital differences between priorities at different levels of NHS administration. At the frontline, nurses and GPs emphasise individual patient needs. Therefore, services with a local presence that are easily accessible to patients are going to be the most straightforward choice for many referrals. On the other hand, commissioners highlight cost-effectiveness and quality of provision because their remit requires them to balance the needs of the area against their budget. Unlike patient referrals, a pre-existing local presence appears to offer little advantage when appointing services, as bringing new providers into the area is part of a CCG’s role. Conversely, cost-effectiveness did not appear as a priority of the GPs and nurses we surveyed, despite increased scrutiny of NHS referrals and the costs they might incur. For frontline professionals, it appears that accessibility and addressing individual patient needs are still the core priorities for referrals.
For charities working with healthcare professionals, understanding the divergent priorities of different roles within the NHS is crucial to tailoring your communications to ensure that your organisation is offering effective support to NHS staff and making compelling bids for commissions.
Unfortunately for organisations hoping to gain insight into these complexities, healthcare professionals (particularly those with CCG roles) are a difficult audience to reach: They tend to be extremely time-poor, and many organisations are competing to speak to them. Our Primary Healthcare Monitor offers an annual, affordable way to gain insight into how best to engage these audiences to ensure you secure the referrals and commissions required to provide effective patient care.
- What questions would your organisation like to ask to GPs and nurses?
- Has the creation of CCGs and CSUs had an impact on your organisation's work?
- Does your organisation consider the needs of NHS staff as well as patients when bidding on commissions or attracting referrals?
- What would your organisation ask commissioners to help inform your bidding for services?
Karen Barker and Rick Wright
If you have any questions about the Primary Healthcare Monitor, please email email@example.com or call 020 7426 8888.