The Commissioning Maze – Health Spending in Your Hands
The Commissioning Maze has proved to be a valuable tool to generate discussion about specific commissioning decisions and challenges faced with the Scarborough and Ryedale area. Events have taken place engaging with the local community, gathering patient and public feedback, which has helped inform CCG Governing body decisions about future priorities for the commissioning of services.
Table of events
11 July 2019 - North Yorkshire Youth Parliment - Whitby Library - 10 attendees
The Communications and Engagement team held another successful Commissioning Maze event in Whitby on Thursday 11 July 2019. The event was attended by members of the North Yorkshire Youth Parliament Group and was supported by Dr Ian Woods and Dr Peter Billingsley. Ages ranged from 12 to 17 years.
At the end of the session, members were asked for their views on the Commissioning Maze. Feedback included, “I did not realise the CCG had to make such harsh decisions” “The NHS needs more money” and “We should learn more in school about the NHS and the costs associated with the services it provides”
The group were very happy to share their opinions and take part in the activity and at the end all agreed that they had learnt a lot more about the NHS and in particular had a greater understanding of the challenges faced.
We aim to continue the strategy to gain feedback from a younger demographic, and to continue to hold similar sessions. We have been approached by Scarborough UTC to hold another Commissioning Maze event to this years cohort, following the success of the event last year.
31 May 2019 - Attended North Yorkshire Youth Parliament meeting - York - 15 attendees
Public Health (optional)
- Young people felt a campaign about legal highs would not be effective and would not be the ‘right way’ to spend £600,000. They felt the money could better be used to support mental health services to help those people who are already taking legal highs. They felt investing in a campaign of this nature was not the responsibility of the NHS.
- The young people were happy to invest £400,000 (and use the money from the general medicine budget). They felt more money needed to be invested in mental health services.
- The group could not see a return on the £200,000 investment and would not choose to invest the money in voluntary sector transport.
- The group was happy to invest £200,000 in a new referral system; they could see the benefit. The money to pay for it ought to come out of the ophthalmology pot, they felt.
- The appetite to invest £1 million in extending GP opening times was mixed. The group felt there weren’t enough GP to cover extended access and would consider investing the money in more GPs instead. With additional money, patients could be given longer than 10-minute slots. However, some people in the group felt the extra opening times could help a lot of people. The group discussed the merits of Skype (some patients would still prefer face-to-face). In the end they felt the investment was worth it – and the money would come out of GP services.
Government Policy Mandatory (you must do)
- The group felt it was appropriate to take the £1 million required to tackle obesity from the general medicine fund as it correlated more with the issue. They considered taking the money out of prescribing, but felt it would be unfair if that affected those who were unable to afford medicine.
- The group was clear that it wanted the £2 million required to be drawn from three budgets – prescribing, general medicine and continuing healthcare.
In the Black (gives you money)
- Happy to take the £200,000.
- The group observed that general medicine covers a range of things and would put the extra £1 million into that fund. The young people were particularly keen to see more money put into patient transport and in schemes which focused on prevention.
- Happy to accept an additional £1 million.
15 November 2018 - Professional Training Event - Filey Surgery - 20 attendees
Successful staff training event, with from line staff from the GP practice. The aim of the event was to give staff a greater understanding and the role of the Scarborough and Ryedale Clinical Commissioning Group.
Feedback from staff who were either new in post and had worked in the practice for a longer period left the event with a greater understanding of the role and the function of the CCG.
“Patients need to be aware of the budgets and understand the NHS cannot provide everything”
“I understand now why some difficult and awkward messages have to be shared with the public”
“It would the helpful if the session could have been longer”
16 August 2018 - Pie & Pea event from hard to reach groups - Ryedale Rugby Club - 30 attendees
A total of 30 representatives from local community groups took part in the Commissioning Maze.
The evening was once again a great success with some familiar faces attending as well as some new groups including Scarborough and Ryedale Carers Resource, Ryedale District Lions, Malton Community Counselling, Horton Housing, Humber FT as well as a Malton Town councillor.
The success of the evening proved how valuable the commissioning maze is as a tool which demonstrates the commissioning process to the public as well as building relationships with local organisations, councillors and patient representatives. Feedback received, agreed that there are “difficult decisions to be made”, and also added it was a “great informative meeting”.
“Just a quick thank you so much for organising and putting so much work into the Ryedale Maze last night; it all worked so smoothly and seamlessly which means a lot of organising beforehand! I hope you felt that the people of Ryedale were enthusiastic and have helped with the work that will now be done to analyse the results, though a serious topic as well as being a great deal of fun; I know the 4 friends who joined our team really found it helpful, interesting and fun.”
16 August 2018 - Filey GP Practice Patient Representative Group (patients and public) - Filey Surgery - 10 attendees
10 members of Filey GP Practice Patient Representative Group.
“Challenging decisions required”
“You have to be very harsh , you can’t have all the services you want”
“I really enjoyed it”
17 May 2018 - Professional Training for Learning Event (Administrative staff from GP Practices) - Coventry University - 25 attendees
Positive comments on the feedback cards included:
“Interesting to learn about the pressures in finance”
“Very informative, learnt a lot about commissioning”
“Fun, enjoyable, thought provoking, understanding”
18 April 2018 - (Students aged 14/15 year) - Scarborough UTC - 27 attendees
27 students aged 14 /15 years as part of Citizenship Class.
“A lot of difficult decisions to be made”
“I would rather have face to face contacts with GP that skype of face time”
“Need to invest in life savings drugs even if this will only extend life for a short period, this is someone’s loved one”
8 March 2018 - Community Group - Spring Café Hunmanby - 6 attendees
“Your life in their hands, some very difficult decisions to be made”
“I wouldn’t like to be the one having to made the decisions and how the money is really spend on a day to day basis”
22 February 2018 - Professional Training for Learning Event (Administrative staff from GP Practices) - Coventry University - 36 attendees
“Have a clearer understanding of the commissioning process and glad I am not involved in making some of the decisions”
“This is an excellent tool to help understand commissioning”
“Difficult to prioritise for limited resource”
“Some very emotive decisions to be made and the need to defend the decision”
“Long term we want to provide more in the community”
“Robbing peter to pay paul, winners and losers”
“Older vs younger – how can you be fair to the whole population?”
Really enjoy it, it is just impossible
“We would defend the decisions we made and explain how we reached the decision”
23 January 2018 - South Cliff Community Group (patients and public) - 20 attendees
“If we are going to take specific action on legal highs then why don’t we do the same with alcohol related injuries or dangerous sports related injuries”
“We have good examples of where incorporating new technology has brought about savings and improved services e.g. diagnostic breathing machines”
“2 million is too much unfortunately to spend on new cancer drugs when they will only benefit 20 people”
“We will get a better service if we have to travel further but we should only have to travel for specialists”
11 January 2018 - Brook Square Patient Representative Group & Practice Staff - 10 attendees
“Public awareness campaigns do not guarantee savings”
“Surplus monies should be kept in savings as a contingent for unexpected situations”
12 September 2017 - Eastfield Patient Participation Group (patients and public) - 7 attendees
“A GP led referral triage service to improve the quality and appropriateness of hospital appointments is a good idea”
“District nurses are trained in end of life care and could provide a number of hospice services in the home”
“We are told by the CCG that most people are happy to travel to receive a better quality service. The locations of some commissioned services should reflect this”
“After initially making considered choices on where to take money from for compulsory investments it becomes more difficult to decide where from and what areas of spending are least deserving – ‘salami slicing’ remains the only viable option”
21 June 2016 - Scarborough locality event (patients and public from hard to reach groups) Pie & Pea Event - Scarborough Rugby Club - 50 attendees
“Services should be centralised where there is higher quality and specialists available”
“If services centralised develop “One Stop Clinics” in more speciality services”
“Charging in A&E for patients with alcohol related issues”
“People to take more responsibilities of their own health”
“Encourage a culture of self-care, reduce prescribing of medication that can be bought over the counter”
“Strong support to invest more in voluntary sector”
Groups attended included:
- Next Steps Ryedale
- U3A Ryedale
- Scarborough Borough Councillors
- Carers Resource – Young Carers
- Hunmanby Residents Group
- Filey Residents Group
- The Older Lesbian, Gay, Bisexual and Trans Association (OLGA) Members
2 September 2015 - Patient Representative Group (patients and public) - 40 attendees
“This has been the most interesting, informative and enjoyable of any previous SRCCG meeting, thank you”
“Have a greater understanding of the difficult decisions and how you have to balance the budget”
“I have a better understanding of the commissioning process”