Delivering quality improvements and cost savings

The Clinical Policy Commissioning and Benchmarking Toolkit identifies key components that contribute to effective end-to-end service and QIPP delivery relating to clinical policy commissioning. Here, we describe the toolkit and the impact it is having.

As part of the NHS England national QIPP Phase II programme, SCW led the development of a Clinical Policy Commissioning and Benchmarking Toolkit. The purpose of the toolkit is to identify key components of clinical policy commissioning that contribute to an effective end to end service and delivery of QIPP targets. Guidance and working templates are provided and can be adapted for local use to establish a best practice baseline. The toolkit has been designed as a system solution which can support commissioners as well as future systems. The principles and recommendations outlined apply equally to individual CCGs, Sustainability and Transformation Partnerships and Integrated Care Systems.

The clinical policy commissioning element of the toolkit outlines the principles of effective governance that commissioners should establish to support prioritisation and development of clinical commissioning policies. This includes Standard Operating Procedures and Terms of Reference to support a Priorities Committee, as well as an Ethical Framework which sets out the principles on which commissioning decisions are made, mitigations against unwarranted variation and minimising the risk of legal challenge. The toolkit provides guidance to commissioners and health communities about the elements that need to be in place to ensure that effective clinical leadership and engagement is at the heart of the process for commissioning clinical policy. It also emphasises the need for clinical policy commissioning to be consistent with the principles of the NHS Constitution and describes the key elements that should be in place for commissioners and health care systems to undertake effective patient and public engagement and formal public consultation. This ensures clinical policy development and commissioning are carried out fairly, transparently and robustly.

The toolkit also includes a benchmarking tool to help CCGs compare expenditure and activity across all policies of low clinical effectiveness (POLCE) or by treatment policy. CCGs can compare against the national average, their STP partners or by their RightCare ‘nearest 10’. This allows for identification of potential opportunities and also highlights CCG areas where activity and spend relating to that clinical policy area have been optimised. CCGs can then compare their policies and clinical thresholds to those identified as ‘better performing’ and review how policies are implemented to maximise the uptake and release of QIPP savings. An interactive map of all CCGs in England with links to local clinical policies is included for ease of access and comparison.

Carl Marsh, NHS RightCare, describes how one CCG was able to use the tool alongside RightCare data to support review of variation in MSK outcomes:

“Herefordshire CCG is currently using RightCare data and approach to review its MSK services, which among other things involves the development of a storyboard”.

“RightCare data benchmarks CCGs to their similar 10 demographic peers but does not always benchmark all procedure types within a programme area.  However, the CCG was able to use the Commissioning Policies tool to benchmark at procedure level to the similar 10 for some MSK procedures (e.g. bunions) not shown in the RightCare MSK pack.”

The Clinical Policy Commissioning and Benchmarking Toolkit is available free of charge to NHS organisations via an N3 connection at:

Associate Director for Clinical Quality