Practice Based Commissioning (PbC) CityCare Alliance Update

Back in June when Practice Based Commissioning (PbC) was just starting to take shape in the district HealthNet brought you a conference aimed at the VCS. The conference aimed to inform the sector about PbC and explore its involvement as both an influencer and provider. HealthNet will keep members informed of the work of the PbC alliances and any relevant opportunities. This is an update on the CityCare Alliance.

Firstly, to recap on PbC in the district as a whole…

Practice Based Commissioning in the Bradford District
PbC engages practices in decisions about the design and investment in health
services, harnessing clinical and system knowledge that exists in primary care.

Alliances
In the Bradford District, four PbC alliances (partnerships of GP practices) have been established:
• Airedale and Wharfedale PBC Alliance
10 practices + 2 independents. Population 93,000 + 11,000
• Yorkshire Primary Care Alliance
15 practices. Population 118,000
• Citycare Alliance
35 practices. Population 146,000
• South and West Commissioning Alliance
23 practices. Population 167,000

each has an alliance manager.

Budgets
The alliances are delegated indicative budgets, Bradford & Airedale tPCT retains overall responsibility and accountability for commissioning. PbC is intended to respond to the identified needs of local people, not to provide extra services that suit providers. The priorities of each alliance differ according to local need. Alliances identify health needs through a range of mechanisms including working with thematic PCT-wide leads for commissioning (e.g. Children’s Health, Substance Misuse and Mental Health).

FURs
As a result of commissioning, Freed up Resources (FURs) are reinvested to target areas of greatest need. VCS partners may be able to provide services and influence priorities through the appropriate mechanisms.

CityCare Alliance

The CityCare Alliance encompasses 35 practices covering a population 146,000.

PbC although by no means concerned only with public health, is the area of interest to the VCS. The CityCare Alliance Health and Wellbeing agenda has prioritised obesity, cardiovascular disease, alcohol, smoking as key issues. Alcohol services will plug the gap in existing services focusing on brief intervention and detox. Breastfeeding support and buddying services will contribute towards infant mortality targets. The obesity care pathway has been developed. Services will include cook and eat, exercise and walking groups. The Alliance recently funded a scheme that will see patients of 14 GP practices within the CityCare area offered vouchers for 12 free sessions at a local Weight Watchers or Slimming World. To be entitled to the vouchers patients must be on a low income and have a body mass index over 30 or high blood pressure For a full article see; http://www.thetelegraphandargus.co.uk/news/news_behind/3743851.A_weighty_matter_exercising_minds/

In the design of local health and wellbeing services front line clinicians, mainly GPs at this stage, identify local priorities and present a business case to the PCT for the services needed to meet those priorities. The tPCT can then decide to commission them. To support this process information will be gathered on what resident’s want, where they want it and at what times. Mapping of existing services and identifying gaps also contributes to the planning process. There is a move towards placing services such as screening, health advice and access to Community Development Workers and Health Trainers within community settings e.g. community clinics and pharmacists.