Loss of commissioning tools could drive up CCG workload

A DoH decision to discontinue its support for the development of two commissioning tools could drive up clinical commissioning groups' (CCG) workload, the Nuffield Trust has warned.

The DoH announced in August that it would not commission national upgrades for the Patient at Risk of Re-hospitalisation (PARR++) and Combined Predictive Model tools that aim to help commissioners predict unplanned hospital admissions.

The Nuffield Trust has now warned that by deciding not to provide these tools centrally, the DoH added ‘another responsibility to the list of CCGs’ responsibilities’.

It said CCGs will now have to ‘get to grips with risk prediction’ and have produced a guidance document to help.

'Choosing a predictive risk model: a guide for commissioners in England' describes the main principles behind predictive risk modelling, the key points to consider when making choices about available tools.

It also provides information about the likely set up and running costs of different options.

Nuffield Trust head of research Martin Bardsley said the financial situation in the NHS makes it ‘even more important’ that risk prediction tools are used to target investment to reduce the need for hospital admissions.

He said: ‘Previously the NHS could access some freely available national tools available in England which were widely used.  

‘These are not being updated centrally and so commissioners will increasingly have to navigate through what is set to become a highly competitive market with all the advantages and pitfalls that that entails.’

But a DoH spokeswoman said it ‘makes sense’ to ask the people using the tools to control their improvements and upgrades.

She said: ‘When the DoH first developed the PARR and CPM tools there was no readily available alternative to support risk stratification. This is no longer the case and moving to local solutions will help to drive a wider range of options and reduce costs overall.

‘The information behind the PARR and CPM tools can be made freely available to anyone who wants to build the tools locally if they want to continue using them.’

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