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Author Topic: HSJ article -World class commissioning could save PCTs £3bn  (Read 2138 times)


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Primary care trusts could save £3bn over five years through world class commissioning, the Department of Health has claimed.

It says if PCTs improve their performance in the health outcomes they have prioritised in world class commissioning by 25 per cent over five years, they will generate around 60,000 additional “quality of life years”. Using its figure of £50,000 per QUALY, this amounts to £3bn.

The figures are set out in an analysis of the health benefits that could be delivered by the commissioning assurance framework. But it warns that PCTs will only achieve this if outcome measures are right, “stretch targets” are set, best practice is spread and commissioners deliver on their strategic plans.

It also begins to flesh out the world class commissioning assurance system for next year.

As predicted by HSJ, the timeframe for next year’s assessment has been put back.

PCT preparation will run from September to December, reports will be analysed between January and March 2010 and panel days will take place in April and May.

The DH is tendering for a partner to help it run the assurance process for 2009-10.

The department’s evaluation of the first year of world class commissioning found most strategic health authorities and PCTs thought the first year of the scheme had worked well, with only “fine tuning” required for next year.

But some staff raised concerns over whether competencies were defined clearly enough.

One SHA respondent said: “The achievement of level two, particularly in competencies six to 10, is a huge challenge… and yet the move from level two to level three is much less of a challenge.”

A PCT respondent said “clear definition” of the competencies was required.

The DH has said it will agree changes to world class commissioning “through consultation with the NHS” by the end of this month.
Readers' comments (6)

   Health Service Journal's reader's Comments

      Anonymous | 1-Jun-2009 2:34 pm

      It would also interesting to know how much has been spent on World Class Commissionining before calculating what might be saved?
      As I reckon that most PCT's are spending a minimum of about £1m per annum on World Class Commissioning. In real terms there will be no money saved over the next 5 years!
      Anybody fancy doing a FOI to find out?
      I imagine the public would have a heart attack and it would deflect attention away from MPs Expenses as in comparison it would be like a rain drop in the ocean.

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      Mary Hawking | 1-Jun-2009 4:55 pm

      I agree with the previous poster - but in addition, where does the figure of £50,000 per QUALY come from, and how does it translate into savings for the PCT?
      After all, most health care costs are incurred in the last 6-12 months of life - regardless of age at death - and no-one has found a way of postponing death permanently yet!

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      Hugo Minney | 1-Jun-2009 9:03 pm

      £50,000 per QALY is an accepted figure is the VALUE of the benefit to the patient, and has nothing to do with the cost or potential saving to NHS - in fact it often costs NHS more to keep someone alive as they may need statins or insulin to maintain their quality of life for an additional year. It's a common misconception, worrying that Department of Health falls into the same trap, and could mean that the Treasury expects NHS to pay the Treasury instead of the other way around.

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      Anonymous | 1-Jun-2009 10:06 pm

      So, the new NHS which is not driven by externally set targets, but has a focus on quality, fits in where exactly with setting 'stretch' targets? WCC is top down setting of standards based on a specification, and has v little to do with quality, let alone being world class.

      If you want world class, scrap the so-called choice agenda. No one else in the world would consider our choice agenda world class. It would be considered an embarrassment to have to offer choice due to excessive waiting times or other poor service performance.

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      Anonymous | 2-Jun-2009 8:32 am

      Two things:

      Stretch targets - damage services. There is no good way to set a target. The DoH are some sort of dinosaur and part of the problem. Performance is a consequence of the system.

      World Class Commissioning: Whenever this old beast is floated it actually results in poor quality and damages services.

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      Anonymous | 2-Jun-2009 1:03 pm

      While agree with poster 1 the cash costs of WCC have to be off set v savings. I feel that the cost to the patient in terms of delays in introducing new services while we fool around ticking WCC boxes before getting them started needs to assessed first!
      A sort of minus Qualy for box ticking and hoop jumping costs.