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Ten top tips for commissioning local rehabilitation services

NHS England has published its first practical guidance to help commissioners understand how best to procure high-quality rehabilitation services

Published on 12th April 2016

Rehabilitation

NHS England has published its first practical guidance to help commissioners understand how best to procure high-quality rehabilitation services and the economic and patient benefits of doing so. Here are 10 Top Tips for commissioning rehabilitation services:

 1. Recognise the rehabilitation you already commission:

Does your clinical commissioning group (CCG) have a listing of all providers and their rehabilitation services?
   
Rehabilitation is essential in order to meet the requirements of domains 2 and 3 of the NHS Outcomes Framework 2015/16

Do you know who commissions level 1 and 2 rehabilitation in your area (NHS England and surrounding CCGs)?

 2.       Have ambition for your services and the people they serve:

Consider encouraging services to start small and then support them to grow

3.       Make your services “join up” and have some common key principles in your service specifications:

Does walking the pathway of care with a user identify any gaps or areas for improvement?

Do you join up with other CCGs? Do you share risk for less common needs and presentations? For example, brain injury rehabilitation is often most effective for populations of 6-700,000

Are there established communication channels between services, including between mental and physical health service providers?

4.       Rehabilitation should not be “extra” or an “add-on” – it should be considered throughout each person’s journey:

Rehabilitation should be part of almost all pathway commissioning

Have you considered how to meet both physical and mental health needs within rehabilitation services?

Have you considered rehabilitation as integral to your sustainability and transformation plans?

5.       Consider what outcomes you want; identify some common measures and ask your services to work together:

Establish what outcome measures are already being collected. Are they robust and can they be used for benchmarking?

What processes are in place to collect information on patient experience? How is this used by providers to improve service provision?

 6.       Consider the range of settings where your services are delivered, especially community settings, the third sector and care homes (including respite care):

Have you commissioned services that focus on care closer to home?

Do your service specifications cover rehabilitation in care homes? This is particularly important for prevention of admissions and maintenance of long-term conditions? What are the governance arrangements?

7.       Take a strategic view so that you invest to save.

Have you considered how rehabilitation can help you deliver primary and secondary prevention and early intervention for your local diverse population?

Have you completed a joint strategic needs assessment for rehabilitation services identifying current inequalities in access and outcomes and future potential demand?

Which services will deliver this across a life course and for particular care groups and types of condition?

Would commissioning self-referral reduce pressure and costs in primary care services?

8.       Cross- check your local services against the rehabilitation model to identify gaps or duplication and outcomes being achieved.

9.       Ask for advice and support if necessary:

 What forums do you use to share good practice locally , regionally and nationally?

10.   Ask your providers and service users how improvements could be made and what can be done differently to improve outcomes for people:

Do you ensure dialogue for improvement and innovation between your providers and service users?

 

Commissioning Guidance for Rehabilitation is available here.

 

 

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