Oxfordshire Clinical Commissioning Group is responsible for buying healthcare on behalf of its population of 654,000, of which 180,000 are aged over 65.
The right time for change
In Oxfordshire, mental health and older people’s services are currently delivered through multiple individual contracts. Steady growth of the over 65s means that the way care is delivered needs to change.
Cobic has been working with Oxfordshire CCG to shift contracts away from activity to outcomes; from episodic, fragmented care to a coordinated approach where the individual receives the care they need at the right place and at the right time. This has included:
- Phase one – Cobic delivered a successful business case for change which evidenced the potential benefits of an outcomes based commissioning approach. As a result, we were asked to support the CCG to ensure outcomes based contracts were in place for 2014/15.
- Phase two – Cobic worked alongside the payers to support them as they engaged with their current principle providers, patients, carers and clinicians to prepare them for outcomes based contracts.
This involved stakeholder engagement work and defining the specific outcomes and indicators that would matter to those using the service. This allowed patients and carers to contribute and to influence and make informed decisions about how their healthcare is delivered. The high-level outcomes and indicators were tested and refined locally and nationally by engaging with clinicians, patients and carers. Further evidence was also gathered through a review of existing published literature and through the support of topic experts. We also used data drawn from extensive individual interviews, and feedback from public and carers at engagement events to validate the outcomes.
The results so far
In early 2014 support was received from an independent Department of Health Gateway Review, and the OCCG Governing Body confirmed their commitment to OBC as a means of achieving the best possible care and value for the people of Oxfordshire.
We are now nearing the end of Phase 3, which brought the local payers (NHS and local government) together to determine whether the existing providers (Oxford University Hospitals NHS Trust and Oxford Health NHS Foundation Trust) are willing and capable to answer the challenge of outcomes based commissioning. This phase also completed the definition in more detail of the requirements and contract details in order to implement the approach in 2015.