Step 1: What population should you focus on?

·Understand population priorities – CCG and locality level

• What do members think needs improving?• What populations are not getting high

value?• Where do local providers feel change is

needed?·Review two and five year plans to align

priorities·Health and wellbeing strategy and JSNA·What does the data say- Right Care information ·Ensure CCG understands potential barriers

Step 2: Define the population – build case for change

·What are the parameters of the patient population, where does it start/end?·Who are the providers/clinicians currently involved·Establish governing body commitment for change and willingness tackle barriers to change·Build a case for change

oReview of existing contracts, identification of risk

oHigh level financial reviewo Identify key areas of potential resistance to

changeoEngagement programme

Step 3: Raise awareness and begin engagement with system (patients, carers, clinicians, providers, other commissioners)

· Awareness of approach and requirements for change across present and potential system

·Proactive expressions of interest to ensure full provider landscape engagement·Personal contact with key system leaders, ensuring clarity on purpose, requirement for change and potential risk/benefits ·Promote, enable and facilitate provider discussion to begin thinking/acting as a system·Engagement plan with patients, public carers. Utilising local groups, proactive session and social media.·Facilitate system wide discussions to test approach

Step 4: Determining the financial envelope

· Identify historic spend for population across system

·Benchmark spend against other like areas·Define financial and contractual parameters to reflect scope of service·Make a value based commissioning decision – what should we spend?

Step 5: Determine the right outcomes for population

· Work with patients, clinicians and provider to determine high level outcomes of service; what benefits& standards should patients expect the health care.

· Determine indicators and measures to demonstration achievement of outcomes

·Set thresholds for indicators

Step 6: Sense check with system

· Understand the level of achievement that may be expected given the resources available

· Informal negotiation with systems of providers

Step 7: Determine the right procurement process

Value based commissioning road

map- initial development and

engagement