The University of Southampton
University of Southampton Institutional Repository

Commissioning of self-management support for people with long-term conditions: an exploration of commissioning aspirations and processes

Commissioning of self-management support for people with long-term conditions: an exploration of commissioning aspirations and processes
Commissioning of self-management support for people with long-term conditions: an exploration of commissioning aspirations and processes
Objectives: To explore how self-management support (SMS) is considered and conceptualised by Clinical Commissioning Groups (CCGs) and whether this is reflected in strategic planning and commissioning. SMS is an essential element of long-term condition (LTC) management and CCGs are responsible for commissioning services that are coordinated, integrated and link into patient's everyday lives. This focus provides a good test and exemplar for how commissioners communicate with their local population to find out what they need.

Design: A multisite, quasi-ethnographic exploration of 9 CCGs.

Setting: National Health Service (NHS) CCGs in southern England, representing varied socioeconomic status, practice sizes and rural and urban areas.

Data collection/analysis: Content analysis of CCG forward plans for mention of SMS. Semistructured interviews with commissioners (n=10) explored understanding of SMS and analysed thematically. The practice of commissioning explored through the observations of Service User Researchers (n=5) attending Governing Body meetings (n=10, 30?hours).

Results: Observations illuminate the relative absence of SMS and gateways to active engagement with patient and public voices. Content analysis of plans point to tensions between local aspirations and those identified by NHS England for empowering patients by enhancing SMS services (‘person-centred’, whole systems). Interview data highlight disparities in the process of translating the forward plans into practice. Commissioners reference SMS as a priority yet details of local initiatives are notably absent with austerity (cost-containment) and nationally measured biomedical outcomes taking precedence.

Conclusions: Commissioners conceptualise locally sensitive SMS as a means to improve health and reduce service use, but structural and financial constraints result in prioritisation of nationally driven outcome measures and payments relating to biomedical targets. Ultimately, there is little evidence of local needs driving SMS in CCGs. CCGs need to focus more on early strategic planning of lay involvement to provide an avenue for genuine engagement, so that support can be provided for communities and individuals in a way people will engage with.
1-12
Reidy, Claire
d500bfe7-7429-4484-b092-60ef0757d0de
Kennedy, Anne
e059c1c7-d6d0-41c8-95e1-95e5273b07f8
Pope, Catherine
21ae1290-0838-4245-adcf-6f901a0d4607
Ballinger, Claire
1495742c-90aa-4074-920e-95e6cc3d5380
Vassilev, Ivo
d76a5531-4ddc-4eb2-909b-a2a1068f05f3
Rogers, Anne
105eeebc-1899-4850-950e-385a51738eb7
Reidy, Claire
d500bfe7-7429-4484-b092-60ef0757d0de
Kennedy, Anne
e059c1c7-d6d0-41c8-95e1-95e5273b07f8
Pope, Catherine
21ae1290-0838-4245-adcf-6f901a0d4607
Ballinger, Claire
1495742c-90aa-4074-920e-95e6cc3d5380
Vassilev, Ivo
d76a5531-4ddc-4eb2-909b-a2a1068f05f3
Rogers, Anne
105eeebc-1899-4850-950e-385a51738eb7

Reidy, Claire, Kennedy, Anne, Pope, Catherine, Ballinger, Claire, Vassilev, Ivo and Rogers, Anne (2016) Commissioning of self-management support for people with long-term conditions: an exploration of commissioning aspirations and processes. BMJ Open, 6 (e010853), 1-12. (doi:10.1136/bmjopen-2015-010853).

Record type: Article

Abstract

Objectives: To explore how self-management support (SMS) is considered and conceptualised by Clinical Commissioning Groups (CCGs) and whether this is reflected in strategic planning and commissioning. SMS is an essential element of long-term condition (LTC) management and CCGs are responsible for commissioning services that are coordinated, integrated and link into patient's everyday lives. This focus provides a good test and exemplar for how commissioners communicate with their local population to find out what they need.

Design: A multisite, quasi-ethnographic exploration of 9 CCGs.

Setting: National Health Service (NHS) CCGs in southern England, representing varied socioeconomic status, practice sizes and rural and urban areas.

Data collection/analysis: Content analysis of CCG forward plans for mention of SMS. Semistructured interviews with commissioners (n=10) explored understanding of SMS and analysed thematically. The practice of commissioning explored through the observations of Service User Researchers (n=5) attending Governing Body meetings (n=10, 30?hours).

Results: Observations illuminate the relative absence of SMS and gateways to active engagement with patient and public voices. Content analysis of plans point to tensions between local aspirations and those identified by NHS England for empowering patients by enhancing SMS services (‘person-centred’, whole systems). Interview data highlight disparities in the process of translating the forward plans into practice. Commissioners reference SMS as a priority yet details of local initiatives are notably absent with austerity (cost-containment) and nationally measured biomedical outcomes taking precedence.

Conclusions: Commissioners conceptualise locally sensitive SMS as a means to improve health and reduce service use, but structural and financial constraints result in prioritisation of nationally driven outcome measures and payments relating to biomedical targets. Ultimately, there is little evidence of local needs driving SMS in CCGs. CCGs need to focus more on early strategic planning of lay involvement to provide an avenue for genuine engagement, so that support can be provided for communities and individuals in a way people will engage with.

Text
Commissioning of Self-Management Support for people with long-term conditions.pdf - Version of Record
Download (1MB)

More information

Accepted/In Press date: 3 June 2016
e-pub ahead of print date: 15 July 2016
Published date: July 2016
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 398455
URI: http://eprints.soton.ac.uk/id/eprint/398455
PURE UUID: 1cee90e7-508c-4588-b10c-c3132d1fc724
ORCID for Claire Reidy: ORCID iD orcid.org/0000-0002-0013-6843
ORCID for Anne Kennedy: ORCID iD orcid.org/0000-0003-4570-9104
ORCID for Catherine Pope: ORCID iD orcid.org/0000-0002-8935-6702
ORCID for Ivo Vassilev: ORCID iD orcid.org/0000-0002-2206-8247

Catalogue record

Date deposited: 26 Jul 2016 09:20
Last modified: 15 Mar 2024 03:47

Export record

Altmetrics

Contributors

Author: Claire Reidy ORCID iD
Author: Anne Kennedy ORCID iD
Author: Catherine Pope ORCID iD
Author: Claire Ballinger
Author: Ivo Vassilev ORCID iD
Author: Anne Rogers

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×