Health care commissioning is a process of “planning and purchasing health services to meet the health needs of a local population” (Kings Fund 2014). It involves a rigorous health service planning with significant clinician, consumer and stakeholder consultation. To complement this process we also use an innovative procurement that focuses on the Quadruple Aim approach.
What is the Quadruple Aim approach?
As health care grows more costly to provide, health care systems internationally have attempted to operate under a Triple Aim framework. Essentially this represents the simultaneous pursuit of three aims- improving the experience of care, improving the health of the population, and reducing per capita costs of care. The Quadruple Aim adds another dimension, improving the work life of healthcare providers.
What principles do we follow in commissioning health services?
In consultation with the Department of Health we follow a nationally developed a set of principles to commission health services. These are:
1. Understand the needs of the community by analysing data, engaging and consulting with consumers, clinicians, carers and providers, peak bodies, community organisations and funders.
2. Engage with potential service providers well in advance of commissioning new services.
3. Putting outcomes for users at the heart of the strategic planning process.
4. Adopt a whole of system approach to meeting health needs and delivering improved health outcomes.
5. Understand the fullest practical range of providers including the contribution they could make to delivering outcomes and addressing market failure and gaps, and encourage diversity in the market.
6. Co-design solutions; engage with stakeholders, including consumer representatives, peak bodies, community organisations, potential providers and other funders, to develop evidence-based and outcome-focused solutions.
7. Consider investing in the capacity of providers and consumers, particularly in relation to hard-to-reach groups.
8. Ensure procurement and contracting processes are transparent and fair, facilitating the involvement of the broadest range of suppliers, including alternative arrangements such as consortia building where appropriate.
9. Manage through relationships; work in partnership, building connections at multiple levels of partner organisations and facilitate links between stakeholders.
10. Develop environments high in trust through collaborative governance, shared decision-making and collective performance management.
11. Ensure efficiency, value for money, and service enhancement.
12. Monitor and evaluate through regular performance reports; consumer, clinician, community and provider feedback, and independent evaluation.