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By Christopher Heginbotham OBE

Wellbeing and fitness and social care commissioning is a values-driven in addition to evidence-driven firm. even though, while there was an expectation that the evidence-base of commissioning may be made absolutely specific, the corresponding values-base has been left mostly implicit. The ebook addresses this topic via an in depth dialogue of values and values-based perform, illustrated with case examples, and by way of constructing a critique of latest commissioning. This strategy allows commissioners to spot and make specific the usually assorted values of all these concerned, no matter if as commissioners, services or clients of prone. It offers a abilities base and different aid tactics for operating with modifications in values held by way of all these engaged in making commissioning judgements. it will be crucial studying for medical professionals, either skilled and in education, commissioning managers, expert employees in NHS origin Trusts and the non-public quarter and all 'at the pointy' finish of perform.

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Sample text

A group of values that has gained in operative momentum over the previous 10 years concerns prevention and health promotion. Although health promotion has been funded by the NHS for the previous 30 years or so, it is only in the last 10 years that it has had wider support. There are a number of reasons for the delay in achieving some traction. First, many senior managers have been, and frankly remain, sceptical of the cost–benefit of health promotion. This is despite good evidence of success in limited areas.

What this means is unclear. Monitor will be limited to tackling specific abuses and unjustifiable restrictions that ‘demonstrably act against patients’ interests’ so as to ensure a level playing field between providers. Monitor will be required to support the delivery of integrated services for patients where this would improve the quality of care for patients or improve efficiency. In short, Monitor’s role remains ambiguous. It may be seriously curtailed by the NHS Commissioning Board which will establish, in consultation with Monitor, the way that choice, competition, service bundling and integration will be effected.

If we are to change the way services are commissioned, preferably for the better, then the loss of PCTs and the opportunity to give resources to GPs and colleagues seemed like a good idea. PCTs had not covered themselves in glory, although maybe they were just beginning to take the necessary decisions and to make inroads into commissioning decisions. Local government, by the same token, had realised that social care commissioning required a 28 3: Health and social care reforms in England closer relationship with health.

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