Response
Response of the Board of Commissioning Oldham Group to the Interim Recommendations of Oldham Health Commission into Fairness.
First of all, the Board of Commissioning for Oldham Group would like to express our thanks to yourself and all the members of the Health Commission for your time and efforts in producing the report into fairness in commissioning. We would also like to congratulate the group on the work undertaken and the report produced.
We welcome the report as a useful framework for fairness and see it as the beginning of a conversation with the public about how the NHS in the borough can be the best it can be in terms of clinical outcomes, patient experience and cost effectiveness. We are clear that key concepts such as “fairness” must be embedded as core principles at the start of our organisation’s formation.
We accept the principles you have set out (free at the point of delivery, choices have to be made, public involvement, allocating resources to tackle health inequalities, focus on prevention, transparency in decision making and keeping the public informed about why decisions are made).
We also broadly agree with the point most members of the group made that although there were no ‘deserving and non-deserving patients’, treatment should not be prioritised for patients who repeatedly choose not to follow clinical advice. Having said that, we would always expect clinicians to go the extra mile to change patient behaviour and we are very mindful of the duty of care which exists to all our patients.
We accept the attributes of fair NHS commissioning you have identified. The Board would particularly like to echo the point made about competition ‘not endangering the viability of any local District General Hospital’. We would go further than this and argue that competition should not endanger the viability of any service. There needs to be an understanding that there are a wide range of providers, not just hospitals as main providers of care and that joined up commissioning would be required to maintain the viability of all services. Emphasis needs to be on the quality of services provided.
We agree that in taking forward the GPCC it will be important to have a diverse mix of opinion and views into the commissioning agenda, as we accept that GPs do not have a monopoly of insights into the needs of patients.
We note the point you have made about avoiding potential conflict of interest. We take this to refer to dual roles of General Practitioners as both commissioners and providers of services. This is something we are very mindful of and will be working to ensure such a conflict cannot occur.
We also share your aspiration to receive ‘high quality real-time patient experience data from providers’. This is likely to take some time to achieve, so I hope the group will bear with us on this.
Overall, we feel the work of the group has vindicated our belief that ordinary members of the public, if fully informed about the issues at hand, will reach a sensible, pragmatic and constructive view not that dissimilar from ‘the professionals’, but with the distinct perspective of those of use the services we commission.
Going forward a new, more meaningful engagement process with patients and the public will be needed, where the needs of communities will be reflected accurately.
The Board has asked Mark Drury to consider how views on the report can be sought, captured and monitored from members of the community who would be less likely to use the website due to barriers around language and internet access.
In conclusion this is a most useful report and I hope something we will refer back to frequently as a ‘fairness test’ as we begin to take over responsibilities from the Primary Care Trust. The Board will be taking forward work to develop patient involvement and this is likely to involve exercises similar to the Health Commission, possibility as an integral part of future Programme Budget areas.
Once again, please pass on the sincere thanks of the Board to all the members of the Commission for your valued good work.
Dr Ian Wilkinson
Chairman
Commissioning For Oldham Group
20.5.11