Commissioning

Commissioning is the continual process of planning, agreeing and monitoring health and care services.  Locally, most commissioning is done collectively for Ashton, Leigh and Wigan by Wigan Borough Clinical Commissioning Group and Wigan Council.

Commissioning covers a whole range of actions and decisions.  See the information below to find out more about commissioning.

Working with public health in the council to assess the health needs of an area

This includes looking at who lives in the Borough, what kind of jobs they do, how educated people are, what type of housing they live in and what health problems are most common.

Looking at these things helps commissioners to decide what services are most needed and what can be done to improve the health and wellbeing of residents.

Designing the way services work

Commissioners have to design how services work and how people can access them. This is often called service or patient ‘pathways’.

Pathways explain to GPs, doctors and nurses what services are for, how patients should be referred in to it, what tests to do and what other support patients might need.  For example, for the ear wax service, the pathway says that patients should be asked to use drops or oil to clean their ears for two weeks before being referred to the ear wax service for wax removal.

Designing pathways is very complicated as there are so many connections and whenever a service changes these connections need checking and reworking.  The people who work in the service and those who use them are often asked to help in designing pathways.  If you are ever asked for your opinion on a service and what can be done to improve it, it will probably be helping to improve the pathway.

Deciding what a service should do

Each of the hundreds of services offered in the Borough has its own service specification.  The service specification sets out what a service should deliver and when.  For example, for the ear wax service, it sets out that patients should be seen within 6 weeks of being referred from their GP and that each ear should be treated separately.

Procuring services and negotiating contracts

Commissioning services means making sure that the right organisation is given responsibility for delivering the service.  This could be an NHS organisation, a voluntary or community sector organisation, or a private organisation.

To do this, commissioners have to put some services out to tender and go through procurement exercises, for example community and mental health services where there are lots of organisations that could deliver the services.

For other services, there is only one provider, for example hospital services within Wigan Borough are all delivered by Wrightington, Wigan and Leigh NHS Foundation Trust as they are the only hospital provider in the Borough.  In these cases, the contract needs to be carefully negotiated to make sure that services are the best possible value for money.

Monitoring how good services are

It is important to make sure that the services that are being paid for are doing their job well and offering residents high quality care.

Commissioners have a small team of people who collect lots of data and patient stories to monitor the quality.  They also go out and visit services to talk with staff and patients, check processes and do a thorough review of the service.

This work supports the work of the Care Quality Commission and Ofsted who also monitor and review the quality of local services.

Visit the ‘How services are commissioned’ page to find out more about how local commissioning works.

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