Martin McShane outlines how the NHS Commissioning Board works and how it supports clinicians, health care professionals and people in the community to enhance the quality of life for people with long-term conditions.

1. Influence, Input and Impact
Dr Martin McShane
Director – Domain 2
NHS Commissioning Board

2. Domains
Saving lives
Supporting quality of life
Putting clinical leadership at the heart of the
NHS Commissioning Board

3. Domains

4. Domain 2 of the NHS
Outcomes Framework
Enhancing the quality of life for people with long-term conditions
2 Enhancing quality of life for people with long-term conditions
Overarching indicator
2 Health-related quality of life for people with long-term conditions**
Improvement areas
Ensuring people feel supported to manage their condition
2.1 Proportion of people feeling supported to manage their condition**
Improving functional ability in people with long-term conditions
2.2 Employment of people with long-term conditions*
Reducing time spent in hospital by people with long-term conditions
2.3.i Unplanned hospitalisation for chronic ambulatory care sensitive conditions
(adults) ii Unplanned hospitalisation for asthma, diabetes and epilepsy in under
19s
Enhancing quality of life for carers
2.4 Health-related quality of life for carers**
Enhancing quality of life for people with mental illness
2.5 Employment of people with mental illness **
Enhancing quality of life for people with dementia
2.6 An indicator needs to be developed

5. Key lines of influence
LAT
Region
LAT
NHSCB
LAT
Region
LAT

6. Influencing the “ecology”
Customers
Providers Regulators
CCG
Practices H&WB
Board
NHSCB

7. The impact of having a long-term
condition

8. Having an impact on long-term conditions
Organisational and clinical
processes
Health & care
Person-
Engaged professionals
centred
informed committed to
integrated
customers partnership
care
working
Commissioning

9. Inputs
• Putting the person with the long-term
condition in charge
• Proactive and accessible primary care
• Consistent, coherent, co-ordinated care across
health and social care

10. Inputs
• Information
– Information for the person with LTC and carers
– Information for providers on quality
– Information for commissioners on value
This will require
• Interoperable data sets
• Business intelligence (NHS number)
• Patient access
– To records
– To professionals
• Face to face
• virtual

11. Better governance of primary care
investment – to restore confidence, trust
Primary Community
Care and MH
£1 £2
Specialist Acute
£3 £6

12. Organisational processes
• Risk stratification
• Care planning
• Admission alerts

13. Working in partnership
• Person and professional
• Professional and professional – MDT
• Generalists and specialists – QI

14. Tracking value
• Experience of the process – replacing
measuring just process alone
• Following value across the health and social
care continuum

15. To have the right impact we need to influence
and create the right inputs across the NHSCB –
to enable and support clinical commissioning
groups to commission in the best possible way
and support quality improvement across
primary care.
Because………..

16. The NHS belongs to the people.
It is there to improve our health and well-being,
supporting us to keep mentally and physically
well, to get better when we are ill and, when we
cannot fully recover, to stay as well as we can to
the end of our lives. It works at the limits of
science – bringing the highest levels of human
knowledge and skill to save lives and improve
health. It touches our lives at times of basic
human need, when care and compassion are
what matter most.