Dropkin, G. Journal of Public Health, https://doi.org/10.1093/pubmed/fdx136
Published: 03 November 2017
Click here to view this article
NHS RightCare is an NHS England programme describing itself as ‘a proven approach that delivers better patient outcomes’. It identifies opportunities for savings and quality improvements, comparing each Clinical Commissioning Group (CCG) with the ‘Best 5’ of a fixed set of ‘Similar 10’ CCGs chosen using equally weighted demographic and deprivation indicators. This article tests whether these indicators are sufficient and equal weighting is appropriate, and evaluates significance.
Robust public data on lung, colorectal, and breast cancer mortality is modelled using the indicators and incidence. Peers chosen using the preferred models are compared with the Similar 10. Confidence intervals are obtained for comparator group averages. RightCare significance is simulated.
Preferred models have unequally weighted covariates. Incidence is the strongest predictor of lung cancer mortality. The ‘Similar 10’ are inappropriate comparators. RightCare significance ignores variability of comparator outcomes, causing 12% Type I errors. Whilst RightCare shows 1842 annual avoidable lung cancer deaths in 80 CCGs, only 168 deaths in 8 CCGs appear exceptional using appropriate peers and CIs.
CCGs cannot expect to match the average performance of the RightCare ‘Best 5’. Until the methodology is examined with data of known quality, claims that RightCare is a ‘proven approach’ are unsubstantiated.
By NHS Clinical Commissioners (2015)
This guide draws on case studies of three different reconfiguration programmes and offers some tips on how to get your engagement right.
Click here to view this guide
By The King’s Fund (2015)
This slidepack presents the key findings from a survey of GPs in six CCGs. The survey explored members’ views of their CCG and its role in primary care. It was conducted by the Nuffield Trust and The King’s Fund as part of a three year project, looking to understand how the CCGs at the heart of the NHS reforms are developing.
Click here to view this slidepack
By NHS England (2015)
This guidance is aimed at CCGs and how new access and waiting time standards for mental health services are to be introduced. It explains the case for change in four areas and sets out the expectations of local commissioners for delivery during the year ahead working with providers and other partners.
Click here to view this guidance
By Monitor (2015)
This report looks at what CCGs are doing about community services as the contracts entered into after the Transforming Community Services programme expire. As contracts expire, commissioners need to consider what options are best for patients. This review of community services commissioning explaining how commissioners can support a move to more co-ordinated care for patients closer to home.
Click here to view this report
By The King’s Fund & Nuffield Trust (2015)
This report, written jointly with the Nuffield Trust, finds that CCGs risk becoming unsustainable without changes to the way they attract leaders and adequate funding to help them expand their remit. The report also highlights concerns that changes to the way primary care is commissioned in England; waning levels of engagement from GPs with a formal role in CCGs; and cuts to CCG management budgets means these bodies risk becoming unsustainable.
Click here to view this report
By Public Health England (October 2014)
This support pack aims to help local areas develop joint strategic needs assessments and local joint health and wellbeing strategies that effectively address public health issues relating to alcohol, drug and tobacco use. It consists of eight resources covering young people’s substance misuse and adult alcohol, drug and, for the first time in 2014, tobacco use. For each topic area there are good practice evidence-based prompts to support local areas to assess need, plan and commission effective services and interventions. The second component for each topic is a bespoke data pack for every local authority to support needs assessment and commissioning.
Click here to view this support pack