ICBs: Move Fast and Leave No One Behind
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- Published: Thursday, 06 July 2023 07:48
- Written by Peter Ingle
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The NHS introduced its “world class commissioning” programme in 2007 and for some time the optimistic phrase appeared on a variety of communications. Along with “high trust environment” it is a three word expression that guaranteed a weary sigh from those dentists who experienced it.
Many NHS contractors hope that with commissioning now passing from NHS England to ICS’s, that dentistry may benefit from local considerations being taken onto account. With 42 ICS’s taking on dental commissioning over a period, there are likely to be significant variations in their approaches. To give an insight into this new world the Conference of Local Dental Committees heard from the Deputy CEO and COO of the Humber and North Yorkshire Health & Care Partnership. This Integrated care system (ICS) serves a population of 1.7 million.
Amanda Bloor, is one of two members of the eight strong executive team with a clinical background, having trained as a radiographer. At the time of the conference she had been responsible for commissioning dental services for eight weeks. She began by saying that ICB’s would focus on outcomes, and to this end wished to reduce fragmentation. This in turn relied on understanding the health needs of the population and the board would need to think holistically and reduce inequalities. Oral health would become an integrated part of their planning.
Jack Lewis, Consultant in Public Health Medicine at the same ICS, picked up on these themes, using the Covid experience as an illustration. He focussed on how inequalities could be reduced, taking the example of vaccination rates. For minorities, the vulnerable, and deprived, they had initially lagged well behind those of the rest of the population. Identifying this had been reliant upon having suitable data. His summary of how the ICB had then improved matters, which he felt was generally applicable, was to “move fast but leave no one behind.”
Amanda Bloor then returned to set out the lessons she had taken from the Covid response. The earlier key messages were repeated, the need for good data, moving fast but leaving no one behind, and establishing partnerships. The COO did accept that the available dental data was poor and expressed a wish to find out “what good looks like.” Looking to new ways of working she asserted that “partnership is the new competition” and gave fluoridation schemes as an example of areas where ICS’s could be involved to the benefit of their public.
A theme that NHS watchers, and those familiar with the former CDO’s plans would recognise was, “making every contact count.” Her example was that dental teams, potentially seeing those who might not otherwise be screened, could have a part to play in identifying cases of diabetes and coronary heart disease.
There was no doubt that ICB’s such as Humber and North Yorkshire are thinking of a lot more than caries and periodontal disease when they allocate their dental budgets. They were, Amanda Bloor said, learning about what she described as an “inflexible contract.” She was aware of the appeal of sessional payments and was ready for a conversation about them.
In conclusion, she said that there was a need to be innovative and find flexibility, while working within the contract.
Delegates had earlier heard the outgoing CDO observe that notwithstanding previous announcements, some ICS’s had “interesting” interpretations of ring fenced dental funding.
Proposals for specific schemes where ICB’s are starting to develop local arrangements, have now appeared, and GDPUK will be covering some of these shortly.
ICB Commissioning
Are ICBs permitted to directly commission local services outwith the national contract?Flexible commissioning is a bit oxymoronic really... as ten times the value of the *flexible* part has to be completed in bog standard UDAs! No matter how sweet the sessional payment is the other 90% might make it financially non-viable to carry on NHS.
How many practices would agree to allocate an emergency appointment per day for the NHS at a set fee?
ICB Commissioning
Are ICBs permitted to directly commission local services outwith the national contract?Flexible commissioning is a bit oxymoronic really... as ten times the value of the "flexible" part has to be completed in bog standard UDAs! No matter how sweet the sessional payment is the "other 90%" might make it financially non-viable to carry on NHS.
How many practices would agree to allocate an emergency appointment per day for the NHS at a set fee?
ICB Commissioning
Are ICBs permitted to directly commission local services outwith the national contract?Flexible commissioning is a bit oxymoronic really... as ten times the value of the 'flexible' part has to be completed in bog standard UDAs! No matter how sweet the sessional payment is the 'other 90%' might make it financially non-viable to carry on NHS.
How many practices would agree to allocate an emergency appointment per day for the NHS at a set fee?
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