“High Quality Assessments with Low Overheads”

Foresight Clinical Services Ltd (FCS) recognises the challenges that NHS commissioners face when securing appropriate specialised services for clients presenting with complex needs. Out of Area (OATS) treatment provision is costly and so the need to ensure that the most cost efficient and clinically appropriate package of care is being purchased is essential. Specialist provision for clients with complex needs in their local community pose a significant challenge to CCGs.

Background

FCS is aware of the four factors that drive clinical commissioning for prescribed specialist services in the 21st century.

• The number of individuals who require the service;
• The cost of providing the service or facility;
• The number of people able to provide the service or facility and
• The financial implications for Clinical Commissioning Groups (CCGs) if they were required to arrange for provision of the service or facility themselves.

FCS believes that through offering a competitively priced independent commissioning assessment service we are well placed to assist commissioners in adhering to these four factors.

Central to any commissioning process must be a clear unambiguous clinical formulation of the client, their needs and importantly an understanding as to how these may be most effectively met within the most appropriate clinical setting. A clearly defined clinical pathway that details the beginning middle and end of provision for each client will enable an understanding of not only individuals’ needs but also over a time assist in the development of a more informed approach to commissioning services for aggregated needs.

FCS offers an independent, stand-alone clinical assessment, formulation and pathway planning service that provides this clinical clarity to assist specialist commissioners to gain a true picture of a client’s needs without the cost associated with seconding existing NHS employees.

We believe that our multidisciplinary network of experienced clinicians enables us to provide the very best in clinical assessment and treatment recommendations at a cost and scalability that is second to none.

What is FCS Informed Commissioning Service?

NHS England literature states that the ambition of NHS England is to bring equity and excellence to the provision of specialised care and treatment. This is a goal shared by FCS.

NHS England emphasise the importance of having a clinical commissioning process in which the patient sits at the centre of both planning and delivery. FCS believe that through offering the Informed Commissioning Service (ICS) we are able to firmly root the patient at the heart of a clinical pathway dedicated to meeting their needs in an efficient, professional and effective manner. Through providing an independent service where FCS have no role in subsequent service provision we are able to provide an open and transparent service that makes clinical recommendations based upon patient need not service availability.

Effective & Focused Commissioning using FCS Informed Commissioning Service

FCS recognises the need to ensure that the principles that drive NHS England and commissioning services also form the foundation to our clinical assessment service. With this in mind we have developed a set of Goals that closely reflect those of NHS England.

Commissioning through Evaluation (CtE)

FCS will ensure that within any commissioning assessment provided recommendations will be made as to measures that can be employed to evaluate treatment effectiveness for the individual client. This will enable commissioners to ensure that they are able to evaluate the purchased care package and identify quickly service providers that are failing to meet the basic needs of the patient.

Case Study

David is a 35 year old man detained under the mental health act following an assault on a woman in his local community. He has a diagnosis of ASD. He currently resides in a medium secure unit and has been there since his offence.

His local commissioning services reviewed David’s placement. This consisted of two senior psychologists, a community forensic liaison nurse, a consultant psychiatrist and the commissioner. The cost of this half day was considerable to reach the conclusion that David could potentially be managed in his local community with appropriate support and structure in place. To get the assessment team together took some 4-6 weeks of planning. The assessment report took a further 5 weeks before it was completed following the team’s visit to see David.

FCS believes that their service of providing the most appropriate assessment team based upon the patient’s presenting clinical needs. FCS can complete an assessment of a client and furnish the necessary report within a four week period from start to finish. The cost saving in terms of NHS staff time and lost clinical productivity is significant when using FCS ICS.

Budget

The costs associated with the ICS package can be honed through economies of scale and centralised contracts. The service can be run either on a bespoke case by case basis which would incur a daily charge rate of £850 plus expenses. This cost covers the time of the expert and all associated work to deliver ICS. Bespoke ‘one off’ rates are the most costly way of delivering a service. If a contract position is agreed we would expect to deliver circa 30% saving on this daily rate dependent upon the length of contract and depth of workload.

Conclusion

In the 21st Century FCS believe that care should be provided to a patient that is of the highest standard. We believe that this begins with a detailed understanding of the patient’s needs and wishes. We believe that our Informed Commissioning Service (ICS) provides a route to aid NHS commissioners and CCGs to meet this goal both now and into the future. We are willing to pilot the ICS service on targeted measurable activities to help all parties generate confidence in such a service.