The pre-election manifesto from the Royal College of Physicians says that clinical leadership is vital to the success of commissioning. In Leading for Quality;the foundation for healthcare over the next decade, the RCP sets out clear policy goals for the future of the healthcare system, including the need for clinical teams and patients to be more fully involved in the commissioning process:
The pre-election manifesto from the Royal College of Physicians says that clinical leadership is vital to the success of commissioning. In Leading for Quality: the foundation for healthcare over the next decade, the RCP sets out clear policy goals for the future of the healthcare system, including the need for clinical teams and patients to be more fully involved in the commissioning process:
Good commissioning depends on the ability to respond to the health needs of the local population and design and deliver high-quality care for patients. In the context of rising co-morbidity and an ageing population with increasingly complex needs, it is essential to agree commissioning frameworks that are based on good information-sharing and recognition of the contributions of clinical teams.The conditions needed to enable this are good local clinical networks, strong clinical leadership in primary and secondary care and supportive management structures, and acceptance that the patient needs to be involved in the organisation of individual care plans.
The RCP wants to see a culture supportive of clinician and patient involvement in the commissioning process, and reforms that encourage teams to work across the traditional boundaries so that patients benefit from high-quality care closer to home. Physicians fully support that vision, and have the flexibility and willingness to embrace new models of care. Many are already at the forefront of developing these services, but are hampered by the current internal arrangements for funding and delivery, which work against the leadership and collaboration needed for an integrated health service:
Under the current tariff-based system, hospitals are encouraged to treat more patients; while under practice-based commissioning general practitioners (GPs) are encouraged to refer fewer patients into secondary care. This tension can work against the development of integrated services that provide the best quality of care for patients, as it becomes financially easier to admit the patient rather than manage their condition outside the hospital or commission separate specialist services in primary care. It is crucial that we rebalance the disincentives by, for example, introducing 'payment by pathway' or 'payment by condition' to ensure that both high-quality generalist and specialist care have a sustainable future for the benefit of patients.
The RCP wants to see an overhaul of the 'payment by results system' so that it supports integrated pathways more effectively.
In the new policy document Leading for Quality: the foundation for healthcare over the next decade the RCP emphasises the role of clinical leadership in commissioning and integrating services and delivering safe, high quality healthcare. It sets out clear evidence-based policy goals in the following areas:
- Improving the healthcare system - leading clinical integration and collaboration; investing in a strong and sustainable medical workforce; delivering safe, high quality healthcare; ensuring the best end-of-life care for patients; and promoting research and innovation within the NHS.
- Reducing health harms - reducing the burden of alcohol misuse, tobacco and obesity; tackling health inequalities and the impacts of climate change on health.
- Physician Development - fostering medical professionalism and leadership; and achieving the highest standards of training.
For further information, please contact Linda Cuthbertson, head of PR, on +44 (0)203 075 1254 / 0774 877 7919, or email Linda.Cuthbertson@rcplondon.ac.uk