Vision & Strategy - Process, product & scope
A key part of commissioning in the new NHS environment is developing a vision and associated high level service strategies set in a realistic financial strategy. The purpose of this work is to establish a long term direction of travel for services, shaped by clear principles about the quality and style of services that the PCT and the local community aspire to.
The Process
There should be substantial clinical involvement from primary care, secondary and tertiary care and public health in developing the vision for future services. Shaping the future pattern of care is a vital role for primary clinicians involved in PCTs.
The PCT will also need to take positive steps to engage with the communities it serves to ensure that the vision commands wide support. It is not just that the collaboration of local people and local organisations will be required to deliver the vision; choice, responsiveness and equity in health and social care are critical elements in improving health, care and the patient experience .
The Product
The development of a vision, associated service strategies and an underpinning financial strategy will provide the PCT with a clear direction to inform all the resultant decisions before it.
The vision and strategies can only create change if they are first understood.
The documents representing that vision need to speak to widely different audiences and it is critical that they be high level and be written in an accessible way. They do rely upon detailed professional work but the challenge to technical specialists is to find simple ways to communicate the import of their work – or use the skills of communications professionals..
The vision and strategies depend on being understood if change is to happen and be sustained. A few clear words and some simple graphics in a short overview publication are most likely to capture people’s imaginations.
Resources
Clinical Engagement Factsheet
Engaging Communities Learning Network
Scope
Important note: this section is about co-ordinating existing plans and putting them into action - not creating yet another document.
The challenge for commissioners is to enhance and realise the national policy and priorities framework through a clear local vision and local strategies to meet the needs of the PCT’s population within the resources available.
The local vision and local strategies should:
- Cover (at least) a 3 year timescale in accordance with Local Delivery Plan (LDP) guidance and reflecting 3 year resource allocation to PCTs (first 3 year allocations were issued December 2002)
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Include national priorities (Priorities and Planning Framework 2003-06: Improvement, Expansion and Reform) and national standards (reflected for example in National Service Frameworks and guidance from the National Institute for Clinical Excellence)
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Demonstrate an understanding of local population needs and concerns through strong involvement processes with local people and key stakeholders (for example the local Oversight and Scrutiny Committee)
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Demonstrate an understanding of local population health status and health inequalities, drawing on Health Equity Audit and the Director of Public Health’s annual report, and make appropriate comparisons with areas with similar characteristics to identify scope for improvement
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Show strong clinician engagement throughout the planning process
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Show that plans are affordable and supported by a financial strategy, with appropriate risk management arrangements (both service and financial risks). Business cases should be assessed against the National Tariff to ensure long-term affordability (although in the short term it is possible that tariff levels could be exceeded)
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Resources
A framework setting out how to translate national strategic objectives into local objectives and key tasks is described in Resource Guide No. 2
Local Delivery Planning 2003 – 2006
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