Operational Delivery and Strategic Commissioning in the NHS Report

This report provides a comprehensive analysis of commissioned services within the National Health Service (NHS) in the UK. It begins with an introduction to the healthcare system's importance and the need to address its challenges. The report then delves into commissioned services, defining the concept and examining the commissioning cycle, including assessing needs, reviewing services, managing risk, and deciding priorities. It explores the impact of commissioned services on key stakeholders like patients, the government, chemists, and nurses. The report further investigates the leadership skills required for effective service delivery, such as maintaining a positive attitude and understanding priorities. It also examines ways to improve organizational performance through the care model. The report concludes with a reflective log and a development plan, offering recommendations for service improvement and discussing relevant government policies related to funding. The report highlights the NHS's efforts to enhance healthcare quality and efficiency through technology and strategic planning.

Operational Delivery and
Strategic Commissioning

INTRODUCTION...........................................................................................................................3
TASK ..............................................................................................................................................3
Commissioned Services...............................................................................................................3
TASK2.............................................................................................................................................7
Investigate ways to improve organisations performance and outcomes......................................7
TASK3.............................................................................................................................................9
Individual reflective log...............................................................................................................9
Development plan......................................................................................................................10
CONCLUSION..............................................................................................................................12
REFRENCE...................................................................................................................................13

INTRODUCTION
The healthcare system has to play a very important role in maintaining the healthy
lifestyle of people by providing all the necessary treatments and health programs. It is also
considered as the backbone of the economy (Ginter and et. al., 2018). The increased problems in
the health sector is been observed and it is required to effectively eradicate them from the
system. The present report will take the NHS organisation which is based in UK, to demonstrate
the aspects of healthcare system. The report will analyse the commissioned services within the
organisation, impact of it on the shareholders, required leadership skills to commission the
particular services, recommendation to improve the services and various government policies in
terms of funding.
TASK
Commissioned Services
Commissioned services can be defined as the care, support or supervision that has been
arranged and paid for the welfare of a client by the public authority like in case of personal care,
a local authority of adult social care department take care, in case of house related support a local
authority housing department and for nursing care the NHS takes the responsibility (Frank,
Glazer and McGuire, 2017).
Commissioning is the continual process of planning and monitoring the services. It
consists of several actions of ranging health needs requirement for the population by the help of
clinically based structure of patient pathways, it also works for service specification and
negotiation or procurement with the continuous quality assessment in effective manner. The
commissioned services in NHS are regulated by the Clinical Commissioning group (CCG) and
NHS England on a local, regional and national level (Duckett and Willcox, 2015).
In early years the health care services was considered as the time consuming process
where a person was required to take appointment, need to consults doctor which included several
body test and then a long time to wait for the reports to carry out the required treatment in
effective manner. But in NHS, the recent developments has mainly focused on health of the
patients and has tried to look from their perspectives. The recent developments implemented
guides the patients to take a good care of themselves and helping them in getting required

knowledge with the help of informations on mobile phones. Organisations are now a technology
enabled and have various devices which measures the health of the people instantly like heart
rate, blood pressure, diabetes, etc.
The commissioning cycle is the process which helps in identifying the ways in which
patients and the public can engage and participate effectively in the different stages of this cycle.
The commissioning will be central to the NHS in meeting the challenges they are facing today
and in they will face in future. It will help them in ensuring NHS to deliver efforts for improved
population health, quality of care and cost control. Commissioning cycle is the strategic activity
that helps in identifying the needs, allocating resources, procuring the provider to attain the needs
with the help of proper sources (Commissioning Cycle. 2010). The various steps considered by
the NHS are as follows:
 Assessing needs: To assess the needs of the people in the health and care services are
done with the help of a systematic process. The care hub services of the people are also
assessed in a systematic manner. The needs are the combination of detailed reviews
gathered from the population particular subject areas, compounding epidemiological and
result based research information and reliable data. This helps in identifying and seek to
destruct the wastage of the healthcare resources. There are different health care sources
which includes clinicians, health care providers, commissioners and also consists of
various practices based on data, community health profiles, housing data, lifestyle data,
etc.
 Reviewing services and analysing gap in provisions : Service reviews are undertaken
to exhibit a complete perceptive of the care hub services that is initiated by the NHS in
relation to the known health needs of the people. It will lead in providing a certainty
regarding the services commissioned are of good quality (Curtis and Burns, 2015). The
required task for this includes understanding the operational delivery, workforce issues,
clinical factors for the services, structuring knowledge in relation with the clinical
effectiveness and evidence base, etc.
 Managing risk: The main aim of the NHS is to provide health care hub services to the
people in staying healthy and protecting them from the various factors that can cause
damage to their health. The government wants the population to make good healthier
choices to reduce the risk of illness irrespective of their circumstances. It can be done

with the help of local services and commissioned in context to fulfil the needs in effective
manner.
 Deciding priorities: It is related with making a certainty that the commission planning
should include the national and local priorities which have to be appropriate (Weinstein
and et. al., 2014). It also concerns of the stakeholders of the care hub services should be
engaged in the decision making process for the local clinicians, patients engagement,
requirements, etc.
 Strategic options: These choices are known in a commission plan which carry together
all the applicable information and data that is needed and further it outlines the ways in
which certainty will be delivered to its important objectives in relation to the care hub
services to enhance the health condition of the patient.
 Contracting: The health care organisations are secure with the different scope of
providers whose primary motive is to perform healthcare facilities, accomplishment of
strategic objectives with the help of acquiring procedure. It consists of market research,
purchasing, procurement, etc. Furthermore, the acquiring process of the care hub services
is the certainty of formal agreements with the applicable providers like acute, primary,
community, mental health, etc.
 Provider development: It is related with integration of constructing care hub services in
the redesigning care paths demanding management and assisting the existing providers to
improve the existing services and to introduce new providers effectively (Mills, 2014).
 Managing the performance of the providers: It is conducted with the purpose of
measuring the performance of care hub services is being achieved or not. It helps in
managing the quality and performance of the commissioned health care in effective
manner. It consists of steps like monitoring and controlling the performances of
contractors against the providers of the services, measures quality with the help of key
performance indicators.

Illustration 1: Commissioning cycle, 2019
Source : Commissioning Cycle. 2019
Data analyses
NHS is a public sector organisation which was founded in the year 1948 and works for
providing health and care services to the people of UK. The NHS organisation will use the care
hub services which uses the healthcare informatics which is a information engineering tool that
can be utilised in the management of health care for keeping the information of patients properly
(World Health Organization, 2016). The care hub services will make a good use of the health
care information techniques with the aim of improving the services with higher quality,
efficiency and better opportunities in the sector. This will not only help the health information
management but also lead in securing the exchange of health knowledge between the consumers
and providers. Overall it will result in increasing the working efficiency of the organisation.

Impact on key stakeholders
Every organisation has definite key stakeholders and they have a great interest in the
success of the organisation. A group of people are responsible in the success of the health care
hub services introduced by the organisation. The key shareholders are as follows:
 Patients : They are the most important part of health care system and the certainty of
their safety is very important. Patients are the normal people and holds a huge stake in the
in this sector and are concerned with the cost, availability and quality of the health
services (Blackwell, Lucas and Clarke, 2014). The most difficult issue that is faced by the
health care organisation is at the time of providing care hub services and to insure safety
of the patients and should provide them with effective treatment at proper time.
 Government: As, the NHS is the public sector organisation, government has a great role
in the administration of the health care. The care hub services handles and manages the
health care efforts by the organisation and makes sure that the activities are carried out in
effective manner or not. It also includes making effective plans and strategies for
managing budget and expenditures in the sector in suitable manner.
 Chemist: They also hold large share in the health sector as they supply medical services
to the customers. They are required to supply the items with good qualities and are
required to keep the availability of the stocks in a sufficient quantity (Ball, Balogh and
Miller, 2015).
 Nurses: The nurses provide proper care to the patients in the care hub services depends
on the level of disease a patient is going through. Nurses help in providing a unique
perspective on the health and care system and plays a very important role in making the
organisation to run successfully.
The Leadership Skills Required For Delivery
 Maintaining a positive attitude: It is very crucial for a leader to have a high spirit while
working in the health care hub services introduced by the NHS. As, it is the work of a
leader to help their staff in maintaining a positive outlook of things so that they can
achieve their goals and objectives.

 Varying work hours acceptance: The working hours for doctors and nurses in the care
hub services are not limited as they can be called at any time for the emergencies by the
medical and insurance teams for the advice.
 Approaching work proactively: The key role performed by a leader in the care hub
services is to have a proactive attitude for things which can be easily communicated by
them in the workplace for the attainment of goals and objectives. As it helps them in
taking care of their patients (Betancourt and et. al., 2016).
 Understanding Priorities and Staying Organized: Overuse of the technology with the
information data system, computer programs and health care machines for the care hub
services need a lot organisational practice.
 Improving themselves and their staff consistently: Leaders are always expected to
have better plans procedures in establishing a healthier arrangement to take care of their
patients effectively and efficiently. If the goals implemented are accomplished then it
will help the organisation in building an effective team and to carry out the care hub
services in successful manner.
 Continuing an education: A professional believes that there can never be a halt in
learning for new information or methods of research which can be used in healthcare and
can limit the pain of a person in reference to any field whether finance, economics,
technology or any other thing (Campbell and et. al., 2016).
Own leadership qualities for delivery
The leadership qualities which the leaders of National Health Organisation in the care
hub services is having a positive work environment which can reduce the stress of the doctors
and nurses and make their job easy. Other than that, the qualities exaggerated by the leaders are
ethics, honesty, showcase respect, confidence and have an attitude to make fair decisions for the
betterment of the organisation, community and the people.
TASK2
Investigate ways to improve organisations performance and outcomes.
The care model

This model focuses on organising and planning approach to improve the services
provided to the patients to take a good care of them. It emphasis on the health of particular
population of patients and provides assurance that every patient will be taken care with the best
medical care services. It also encourage a transformation on care delivered by the doctor and the
services delivered by the teams. Each team member comes with their own expertise to the table.
NHS will exercise this model in the working environment as it has earned international
recognition for identifying the key elements of health care system in effective manner and also
boost high quality care (Drummond and et. al., 2015). It comes with the five key elements which
are health system, delivery system design, self management support, clinical information system
and decision support.
Illustration 2: Care Model, 2019
Source: The Care Model. 2019

Gaps in the health care delivery
The problems faced by the organisation are defined as follows:
 Less availability of physicians: The main problems faced by the NHS organisation is
that there is less availability of the physicians who holds the important role in the health
care system. The reason for this loss is that government is cutting the reimbursement
rates of the physicians. Because of this many physicians have refused to accept the
medical recipients.
 High cost of medicine: It is one of the most important component of making profit in the
health care system. The continuous increase in the cost of primary medicine for treatment
is one of the serious issues. NHS will be required to conduct a effective research for the
development of the new drugs to curing the major diseases in effective manner.
Evaluation and Creation of Flexible Strategies:
The establishment of new strategies to make the workforce of the National Health
Organisation more flexible in their duties, roles and even by introducing the new staff in the
work to limit the workload of the existing staff (Enthoven, 2014). Therefore to do that NHS has
established the following strategies:
 Smart move by the organisation: The following strategy suggests to keep the staff of
the hospital more efficient by having a optimized process development of skill
management, safe investment and easy to use technology. The technology can be used to
minimise various costs of training and helps in limiting the use of high qualified staff in
the delivery chain.
 Ensure Customer Satisfaction: A patient need to be satisfied in the order of
competitiveness, as it is the work of doctors, nurses and staff to keep them happy against
them keeping healthy for the organisation to remain financially sound. The power of a
satisfied customer remains in the hands of physicians in keeping up with the patient
desires. The technology and the procedures in the hospital is need to be designed in such
a way that it enhances patient expectations and satisfaction.
New Market Forces

With the advancement in the business world, the changes can be marked in the health
care system as the market forces are increasing rapidly. The market forces used by the NHS will
be:
 Payment method: The usage of NHS services are free cost for the patient till a point, but
the real payers are the people of United kingdom. The NHS can try to deliver more better
facilities to their patients according to the funds accessible to them
 Customer Expectations: The technology is changing rapidly in the area of health and
medical facilities available currently, so the patients expects a quicker results (Enthoven,
2014). It can only be achieved by the more advanced machinery and technology like
machine for checking diabetes and heartbeats, which can be used to know about the
treatment procedure as well.
TASK3
Individual reflective log.
In the above section I performed the task to explain the improvements which are required
in the health care sector and the chosen organisation was the NHS which performs their function
in UK. I carried out a effective analysis by identifying, analysing and developing suitable action
plan to provide a appropriate solution for the organisation. To analyse the conditions of the
health sector I tried to assess the views of the people about the system and while doing that I
interacted with lot of patients. The interactions with them directed me towards the result that they
all were not satisfied with the services rendered to them. They all had common problem with the
system that the services provided were not up to the expectations. I tried to convince them that
the management is working with the motive of improving the health care system in effective
manner. I defined the new and effective methods the management is planning to improve the
health care system for the benefit of the users. It was really time consuming and it cause many
problems for me to manage my other works in effective manner. After analysing the problems
faced by the people i consulted the issues with my seniors and subordinates. We all made a
intense discussion about it and planned to solve with immediate effects as these issues will
continue to grow and will result in making the conditions more worst. It was also resulting in
increasing the cost of treatment which is a serious issue for the patients as they are unable to
match the bills of health care and are compromising with their treatments.

While conducting this evaluation I gained immense experience about the field of work
and helped me increasing my skills and capabilities of understanding a situation and perspective
of both the sides. To develop a commissioned cycle is a very challenging task as it consists of
many tasks in itself and making evaluation of all of them made me gain adequate amount of
knowledge that will help me with my future projects as well with more efficiency.
At the time of making analysis on the impact of stakeholders, I went through a lot of
problems because of my poor communication skills. I can handle the writing part effectively but
at the time of making direct conversation with the people make me feel of this disadvantage i
possess. My leadership skills were competent enough to lead my team in a proper manner. at the
time of devising the problems or the gaps faced by the organisation i came to know that it is
important to improve my leading skills in order to motivate the people and encourage them to
work in a productive manner to accomplish the desired goals. While working on this project
there were times when the team conflict occurred and i was unable to solve them, which resulted
in creating bad effect on the team.
I am able to achieve business goals and objectives effectively. This was an astonishing
experience for me as it has taught me a lot of things. The most important thing which I have
erudite is developing confidence, to work in calm and composed manner, listening to the views
of everyone carefully and then develop plans and policies so that needs and requirements of the
people are accomplished in effective manner.
There were many people who has bucked up and motivated me while carrying out this tasks
because all people involved were solicitous about the betterment in the system and only initiatory
was placing grandness. When I stressed on this, then people were so blissful because even they
desired to use the progressive technologies in the method which is accommodating for the
organisation as it create quick outcome and also helpful for the patient because rapid treatment
can be started.
By building team spirit, I have gained the trust of people. They now realise the value of
working in a team and I am feeling extremely contented that because of my skills and abilities,
they have not only formulated effective team but has also accumulated on understanding its
importance. Team working always produces productive and efficient results for the company.
I have also experienced insufficiency of time and this is because, I was not able to plan
the things properly. This time disappointed me because I was not able to carry through the

targets on time. This may be because I was slow at my work or not taking the time seriously. At
this point, I apprehended the value of time and has utilised several strategies in my work which
assisted me to carry off the time and work in effective manner. In this, I realised that how time is
to be managed by planning the every work schedule and completing the same before the set
targets.
Development plan.
What do I want
to learn?
What do I have
to do?
What support
and resources
will I need?
How will I
measure
success?
Target date for
review?
I want to gain
knowledge of
communication
skills because I
am not good in it
and whenever I
speak in public I
feel hesitate.
For getting better
communication
skills I have to do
practice on a
regular basis and
to speak in with
my friends &
family a lot so
that I can get the
flow of
communication
and can remove
my uncertainty.
Support and
resources which I
need for getting
better my
communication
skills are
confidence
classes. It teaches
to deal with this
problem and from
where I can learn
how to speak in
front of a lot of
people.
I can measure my
success by simply
asking people to
genuinely observe
me while I
communicate
with others
I need 90 days to
improve my
communication
skills.
I want to learn a
leadership skill
because I am not
good in handling
people or
controlling them
because of which
For wisdom of
leadership skills I
have to take
training which
can educate me
how to be
oppressive and
A resource which
I need to improve
my weakness is
that I need to hire
a trainer which
can endow with
training for being
I can measure my
success by asking
people who are
working under
me or by self
assessment. I can
also measure it by
I'll be needed 30
days for learning
these skills.

people does not
take me seriously
sometimes.
can perform all
the leadership
roles.
a good leader. asking someone
from my
workplace to
observe me while
I perform my
leadership skills.
I must to learn
some problem
solving skills
because I am not
good in it and it
causes a lot of
dilemma for me.
To learn these
skills i need to
take proper
guidance from my
seniors and
should read books
of this topic.
Proper guidance
notes and books
to improve my
skill in effective
manner.
By applying my
knowledge in the
practical world
and by handling
future team
problems in
effective manner.
It will take
around 60 days to
gain appropriate
knowledge.
CONCLUSION
From the above report it can be concluded that enhancement in the health and care
systems is very important as it provide help and assistance to the people. This is very vital
because in today's world where the business environment is extremely dynamic in nature, so the
organisations are obligatory to stress on different tools and techniques which can help in
amending the health services. For this reason, organisation has developed the leadership skills,
formed a range of strategies like customer satisfactions and also developed the new forces like
payment methods and gathering customer potential.

REFRENCE
Books and Journals
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Academies Press.
Betancourt and et. al., 2016. Defining cultural competence: a practical framework for addressing
racial/ethnic disparities in health and health care. Public health reports.
Blackwell, D. L., Lucas, J. W. and Clarke, T. C., 2014. Summary health statistics for US adults:
national health interview survey, 2012. Vital and health statistics. Series 10, Data from
the National Health Survey .(260). pp.1-161.
Campbell and et. al., 2016. Transition of care for adolescents from paediatric services to adult
health services. Cochrane Database of Systematic Reviews, (4).
Curtis, L. A. and Burns, A., 2015. Unit costs of health and social care 2015. Personal Social
Services Research Unit.
Drummond and et. al., 2015. Methods for the economic evaluation of health care programmes.
Oxford university press.
Duckett, S. and Willcox, S., 2015. The Australian health care system (No. Ed. 5). Oxford
University Press.
Enthoven, A. C., 2014. Theory and practice of managed competition in health care finance.
Elsevier.
Frank, R. G., Glazer, J. and McGuire, T. G., 2017. Measuring adverse selection in managed
health care. In Models of Health Plan Payment and Quality Reporting (pp. 29-57).
Ginter and et. al., 2018. The strategic management of health care organizations. John Wiley &
Sons.
Mills, A., 2014. Health care systems in low-and middle-income countries. New England Journal
of Medicine.370(6). pp.552-557.
Weinstein and et. al., 2014. Telemedicine, telehealth, and mobile health applications that work:
opportunities and barriers. The American journal of medicine.127(3). pp.183-187.
World Health Organization, 2016. Guidelines on core components of infection prevention and
control programmes at the national and acute health care facility level. World Health
Organization.
Online
Commissioning Cycle. 2010. [Online]. Available Through
:<https://webarchive.nationalarchives.gov.uk/20100402133525/http://www.ic.nhs.uk/
commissioning>.