Healthcare delivery and Strategic Commissioning

Running Head: Strategic Commissioning
Healthcare delivery and Strategic Commissioning
Report
System04104
3/16/2019

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Introduction
Healthcare is known as an ever-progressing system in all over the world. The advancement
and development in the healthcare sector are quite rapid. The new tools and technologies are
developed every day with growing needs of quality healthcare services. To adopt frequent
change according to this rapid growth in the healthcare sector is practically impossible. Thus,
we need to adapt and accept the changes with some strategic plans that meet the challenges of
new diseases in healthcare services (Jones, 2012).
This report is based on the role of commissioning in NHS England. It provides an approach
towards the strategic plan for healthcare organisations. This report shows the impact of
strategic decisions and the role of commissioning in healthcare service delivery. This report
also sheds some lights on the role of leadership in healthcare service delivery and role of
commissioning to determine the standards of service quality.
Role of Strategic Management within the Complex and Challenging
Context of Delivering Health Services
Health care is one of the progressive systems that changes and grows with the rapid growth in
technology and people need. Over the last three decades, types of diseases, cost of care,
public awareness and their participation in treatment, involvement of people in fighting with
some dangerous diseases, and involvement of regulatory bodies in healthcare have all
received the public attention. However, very less attention is given to such changes that
affected the health care quality and control system. The continuous development in the
healthcare delivery system required new standards of care that helps to match the changes in
the healthcare system. Healthcare is a dynamic and continuous developing system that
requires a dynamic and strategic system for its management. The old management by
objectives system is meaningless and not effective in modern healthcare service delivery.
Thus, there is a need for every healthcare organisation to focus on a dynamic management
system.

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NHS England and Healthcare
NHS is one of the leading healthcare organisations in England and is known for its strategic
plan in healthcare services. A clear and strategic management plan helps the healthcare
organisation to reduce the cost of service delivery in the healthcare organisation. A good
strategic plan in NHS healthcare organisation helps in ensuring equality of services for the
patients. NHS is known for its healthcare policies and strategies. NHS annually updates its
provision related to healthcare standards because it is the statutory duty in NHS England. To
carry out these changes in the healthcare organisation, NHS spent a huge amount on the
strategic change in delivering healthcare services. The NHS in England uses a wide range of
approach to improve its healthcare service delivery standards and planning a sufficient budget
for healthcare organisations (GOV.UK, 2018). Commissioning plays an important role to
implement these changes in the healthcare organisation. Commissioning is the process of
analysing needs of healthcare organisation and then planning and prioritising these needs by
purchasing and monitoring healthcare services. Healthcare commissioners are appointed in
the NHS England to ensure the standard quality of healthcare services. These commissioners
are also responsible for the quality of care and cost control.
Models and Frameworks relating to procurement and Commissioning
of Healthcare Services in NHS England
There are different models under CCG (Clinical Commissioning Groups) which helps in
procurement and commissioning of healthcare services. Healthcare commissioners are
responsible to ensure that sufficient and standard services are provided to the patients (Field,
and Oliver, 2013). Apart from this, some model helps in providing appropriate healthcare
services to society at a very low cost. The popular three models in healthcare commissioning
are as follow:
1. Prime Contractor Model
In this model, the CCG contracts with a single healthcare organisation that further contacts
with other sub-contractors for commissioning and procuring healthcare services. The CCG is
responsible for the commissioned services while the prime contractor holds other each sub-
contractor for their accountability. In this model, the prime contractor designs all the delivery
and procurement model and patient pathways that most effectively meet the terms of the

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contract. The prime contractor helps the other sub-contractor in the procurement of
healthcare services (Policy, 2013).
(Source: Wenzl, McCuskee, and Mossialos, 2015)
The major disadvantages of prime contractor model for procuring healthcare services are as
follow:
1. It includes high financial risk for the prime contractor.
2. Problem for management
3. Suppliers of the healthcare services may not have sufficient skills for contracting or
commissioning.
2. Prime Provider Model
This model is an extension model of prime contractor model in which the contacted
organisation also delivers care for the healthcare products and services which is the part of
the agreement. Just like prime contractor model, the prime provider of healthcare services
receives sufficient capital budget for all the care mentioned in the contract. The prime
provider can also purchase some new healthcare from the sub-contractors services from this
budget that it cannot deliver directly.