Health Service Focus


Making place-based commissioning a reality with digital

Source: NHE May/Jun 17

During e-Health Week a panel of experts discussed the benefits of place-based commissioning. NHE's David Stevenson reports.

Back in 2015, The King’s Fund published its ‘Place-based systems of care: A way forward for the NHS in England’ report. It argued that NHS organisations need to move away from a ‘fortress mentality’ and that collaboration through place-based systems of care offers the best way to tackle the growing challenges facing local health economies. 

During a recent panel discussion on using digital to make place-based commissioning a reality, Dr Michael Dixon, chair of the College of Medicine, who is a strong advocate of social prescribing, said his challenge to technology and suppliers was to work better for patients. 

“The chance for digital will be to offer the transactional services where appropriate, and supplement and support personal services where it is necessary,” he said, adding that as we move towards place-based care the patient is “no longer people we do things to, they become part of the provider system”. 

Dr Justin Whatling, vice president of population health at Cerner, told delegates at e-Health Week the NHS has a good opportunity to learn lessons from the US and “develop place-based care where it is a lot more holistic within individual geographies for how they join up the experience for the citizen, but also the professionals working in that care system”. 

“I think we are going to see a bit of a shift from documentation systems into planning systems, and then integrating planning systems of citizens and professionals working well together,” he said. “We will see a shift with this intelligence, and technology has a huge opportunity.” 

He also reflected on the Nuka Care experiment in Alaska, which included a whole-system redesign which has broken down barriers between primary care, community services, mental health services, and hospital specialists. 

“It was a huge change to get there, but it’s the sort of thing the Five Year Forward View (FYFV) is talking about with clinician hubs serving 30,000-50,000 people,” said Dr Whatling. 

“I think a lot of people are designing new care models, but they are being held to account in the old way of working while being asked to do the new way of working. The answer to that has to be local innovation, but they need to be supported on that journey. The next step of the FYFV is trying to make that a bit clearer, and as we move to accountable care organisations (ACOs) the centre will help and relax some of these things. 

“My view on sustainability and transformation plans (STPs) is that they are there to transition and help incubate ACOs.” 

NHS doctor and global healthcare IT strategist Dr Saif Abed added that, taking technology out of the equation, any form of reform in healthcare, whether successful or not, comes down to a few words: “people, processes, incentives, funding, support and leadership, and last but not least, politics”. 

“Technology is an enabler, but on its own is simply not enough,” he said, adding that it is incumbent on all of us in the system to take a longer-term view. 

“We can’t be short-termist or have a fortress mentality – we can’t simply focus on what is good for my organisation any longer. STPs, as they stand today, are documents. It is about people, processes and execution to make them work. And to give them the time to actually work,” argued Dr Abed. 

“There will be hiccups, there will be challenges; we have to expect those and get through with them. 

“But it is dependent on the people, the processes and the leadership and not least technology organisations that will ultimately make placed-based commissioning a success.”

Tell us what you think – have your say below or email


There are no comments. Why not be the first?

Add your comment


national health executive tv

more videos >

latest healthcare news

Traffic light system could reduce hospital waiting times

24/04/2018Traffic light system could reduce hospital waiting times

A pilot system is making it easier for GPs to understand the hospital waiting times experienced by their patients. The e-traffic light system co... more >
Ambulance workers threatened with weapons and sexual violence

23/04/2018Ambulance workers threatened with weapons and sexual violence

Sexual assaults on ambulance workers have almost trebled in five years, a Freedom of Information (FoI) by union GMB has revealed. Since 2012 the... more >
RCN seeks views on three-year pay deal

23/04/2018RCN seeks views on three-year pay deal

The Royal College of Nursing (RCN) has opened its vote for its members to have their say on a three-year pay deal. If approved, the deal would s... more >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital e... read more >

last word

Hard to be optimistic

Hard to be optimistic

Rachel Power, chief executive of the Patients Association, warns that we must be realistic about the very real effects of continued underfunding across the health service. It’s now bey... more > more last word articles >
681 149x260 NHE Subscribe button

the scalpel's daily blog

NHS long-term funding: what’s in store?

10/04/2018NHS long-term funding: what’s in store?

Anita Charlesworth, director of research and economics at the Health Foundation, discusses Theresa May’s recent announcements on long-term NHS funding and considers the options available. The prime minister’s appearance in front of the Liaison Committee of the House of Commons last month has caused quite a stir in the health world and no doubt a fair amount of angst in the Treasury. This is not the first time a prime ministe... more >
read more blog posts from 'the scalpel' >


Building a solid evidence base

18/04/2018Building a solid evidence base

Danielle Doyle of THIS Institute, co-created by the University of Cambridge and the Health Foundation, says the new organisation will dare to try... more >
Forensics v fraud

18/04/2018Forensics v fraud

Gareth Ballance, technical lead of the Forensic Computing Unit (FCU), gives a snapshot of a day in the life working for the NHS Counter Fraud Aut... more >
A personal view of NAPP’s future strategy

18/04/2018A personal view of NAPP’s future strategy

Dr Patricia Wilkie, president of the National Association for Patient Participation (N.A.P.P.), outlines her personal ambitions for the coming ye... more >
It’s all about quality data

18/04/2018It’s all about quality data

Steve Graham, eProcurement/Scan4Safety lead at the Department of Health and Social Care (DHSC), and Gillian Fox, head of the eProcurement Program... more >
Setting the reform agenda

18/04/2018Setting the reform agenda

In 2017, the National Audit Office (NAO) said the government needs to take a stronger and more integrated approach to rein in the cost of clinica... more >


Duncan Selbie: A step on the journey to population health

24/01/2018Duncan Selbie: A step on the journey to population health

The NHS plays a part in the country’s wellness – but it’s far from being all that matters. Duncan Selbie, chief executive of Pu... more >
Cutting through the fake news

22/11/2017Cutting through the fake news

In an era of so-called ‘fake news’ growing alongside a renewed focus on reducing stigma around mental health, Paul Farmer, chief exec... more >
Tackling infection prevention locally

04/10/2017Tackling infection prevention locally

Dr Emma Burnett, a lecturer and researcher in infection prevention at the University of Dundee’s School of Nursing and Midwifery and a boar... more >
Scan4Safety: benefits across the whole supply chain

02/10/2017Scan4Safety: benefits across the whole supply chain

NHE interviews Gillian Fox, head of eProcurement (Scan4Safety) programme at NHS Supply Chain. How has the Scan4Safety initiative evolved sin... more >
Simon Stevens: A hunger for innovation

25/09/2017Simon Stevens: A hunger for innovation

Simon Stevens, chief executive of NHS England, knows that the health service is already a world leader when it comes to medical advances – ... more >