In the new commissioning landscape emerging in response to the Health and Social Care Bill there is an expectation that nascent consortia and directors of public health will forge close working relationships. Also, the proposed health and well-being boards will need to work closely with consortia to identify priority commissioning areas.
GPs are unclear about the nature and consequences of the new public health systems to be established for health improvement, protection and services. The agenda, systems and approach are all new.
Consortia therefore need to get involved with, and understand the value of public health - particularly over the interest they and public health clinicians share on health improvement and developing services.
At a recent NHS Alliance and Quality, Innovation, Productivity and Prevention (QIPP) Right Care Summit (see www.sph.nhs.uk) an urgent need for a framework for consortia to understand the new public health systems was identified. This would help clarify how consortia will access public health skills needed for commissioning health services.
Currently, practice-based commissioning has involved public health input for prioritising PCTs' healthcare planning. This has been supported by the joint strategic needs assessment (JSNA) produced by local authorities in conjunction with public health consultants.
GP commissioners can then try to understand, in light of their personal knowledge of their healthcare populations, how best to influence health-care commissioning.
Strategic planning process
In the new environment, GP consortia need to be involved in this planning process at a much earlier stage to influence the JSNA and strategic planning. They can achieve this by working closely with public health colleagues, who are also key in supporting decision-making and service change.
As we transfer to the new systems, GPs will need support in understanding the public health agenda. I use these techniques effectively with public health colleagues:
- Learning sets based on a specific project to underpin joint learning for public health and primary care as the JSNA is developed.
- Web-based learning can provide consortia with a valuable resource to inform pathway redesign and health priorities in their commissioning aims in relation to the JSNA.
- Facilitated workshops offer another opportunity to learn and collaborate on specific topics.
GPs and public health clinicians will need to work together to improve the health and well-being of the population and facilitated joint planning can overcome challenges. Consortia must be involved in the planning process at a much earlier stage to influence strategic planning.
From my own experience of working with Thames Valley public health colleagues, I know collaboration can be effective.
- Dr Rawlinson is a GP in Ascot, Berkshire.