1. Commissioning for
Value
A programme to help CCGs identify
value opportunities and improve
healthcare for their populations
September 2013

2. 2
Commissioning for Value is about identifying priority
programmes which offer the best opportunities to improve
healthcare for your populations; improving the value that
patients receive from their healthcare and improving the
value that populations receive from investment in their local
health system.
Commissioning for Value – September 2013
What is Commissioning for Value?
“Value in any field must be defined around the
customer, not the supplier. Value must also be
measured by outputs, not inputs. Hence it is
patient health results that matter, not the
volume of services delivered. But results are
achieved at some cost. Therefore, the proper
objective is… patient health outcomes relative
to the total cost (inputs). Efficiency, then, is
subsumed in the concept of value. ”
Source: Porter ME. (2008). What is Value in Health Care?
Harvard Business School.

3. The Commissioning for
Value approach begins
with a review of indicative
data to highlight the top
priorities (opportunities)
for transformation and
improvement.
This is achieved using
Programme Budgeting
Marginal Analysis and
Spend and Outcome data
to highlight those clinical
programmes where the
health economy is an
outlier and therefore will
be most likely to yield the
most improvements to
clinical pathways and
policies.
The approach - where to look...using indicative data
3

4. Commissioning for Value – September 20134
Quality
Spend Direction
of Travel
Bespoke Commissioning for Value insights packs CCGs
By mid-October, we will deliver bespoke
Commissioning for Value packs to all
211 CCGs, with an offer of follow-up
events and support.
These packs will have triangulated data
for the top Programme Budget
Categories by spend for your population
and will suggest priority programme
areas which offer the best value
opportunity for service improvements

5. Commissioning for Value 20135
How will using this pack benefit my population?
• Achieved Turnaround (Warrington CCG - Winner of HSJ Commissioning Organisation of the
Year 2012)
• Financial sustainability (West Cheshire CCG - Winner of HSJ Commissioning Organisation of
the Year 2010)
• Clinically led annual QIPP planning and delivery (Borough of Wigan) Clinical Leaders driving
change (Vale of York CCG)
• Galvanising commissioners in a growing number of health economies (20+ CCGs and
growing)
CCGs can and are using
the “Right Care approach”
to shift spend
Year 1 – “Came from behind” - Implemented system mid year
Year 2 – “Delivered as went along” - Began at year start, achieved by end
Year 3 – “Planned ahead” - Began before year start, over- achieved
Year 4 – “Ahead of the curve” - 20% of QIPP delivered by start
Year 5 – Increased focus on Quality!
Achieving financial
stability in West Cheshire
It’s not just about money -
Right Care in West
Cheshire led to real
quality improvements in
just one annual cycle
- A&E attends & admissions, Elective & Non-
elective activity, OP Firsts and –
- Follow-ups – all decreased
- Outcomes & Quality – improved
- Integration occurred across health sectors
and with social care
Enabled by, for example :
- Medicines administration training to care
homes
- Personalised care plans (LTC)
- Community
endoscopy, optometry, ophthalmology, neurol
ogy & pain management pathways
- MRI Scanner Direct Access

6. • Constant clinical focus on improving quality and outcomes
• Significant engagement from constituent practices
• Involvement of the wider clinical community in commissioning
Domain 1
A strong clinical and multi-
professional focus
• System-wide strategic planning
• Evidence based operational planning
• Effective delivery of the plan
Domain 3
Clear and credible planning and
delivery
• CCG is clinically led and properly constituted with the right
governance arrangements
• Delivers statutory functions efficiently, effectively and economically
• Procures high quality support as required to meet the business
needs
Domain 4
Robust governance
arrangements
The use of these packs and the approach described can help CCGs develop the strategic
commissioning skills necessary for delivering quality care today and transforming services
for tomorrow, as outlined in the following 3 of the 6 assurance domains:
How will using this pack help my CCG Development
6

7. 7
• understand what the insight packs are telling you about your population health
outcomes
• how to use the insights in the packs to direct your improvement efforts
• learn from early adopters who have successfully used this approach to deliver
results
• get face to face support in surgeries where your insight packs can be
discussed on an individual, CCG basis
• network with commissioning support services who can help you to move
forward
To support CCGs in making use of the insight packs, we are organising two
follow-up events to help CCGs:
Commissioning for Value 2013
Two follow-up events for CCGs…

8. 8
London: Manchester:
Venue: The Business Design
Centre
Venue: Mercure Hotel, Manchester
Piccadilly
Date: Tuesday 12th November Date: Wednesday 13th November
Time: 9:30am for 10:00 start Time: 9:30am for 10:00 start
An online registration form is available at the URL below:
www.rightcare.nhs.uk/commissioningforvalue
Commissioning for Value 2013
Book your place online…

9. 9
The Right Care website will offers a new Resource Centre to support
CCGs including:
• Online videos and ‘how to’ guides
• Theme based Webinars
• Case studies with learning from previous pilots
• Tried and tested process templates to support taking the
approach forward
• Advice on how to produce level 2 packs locally, within the CCG or
working with local intelligence services
Commissioning for Value 2013
www.rightcare.nhs.uk/resourcecentre
Other resources to help get the most our of Commissioning for Value