Evidence based commissioning: calculating shift potentials for paediatric services

• Published in: Clinical governance 2013, Vol.18 (1), p.39-48
• Main Authors: Barnes, Katie, Longfield, Philip, Jones, Katie, Littlemore, Gill, McDonough, Claire, McIntyre, Archie, Robertson, Jo, Turton, Neil, Urdhin, Kevin, McLaughlin, Melanie
• Format: Article
• Language: English
• Subjects: Age groups; Ambulatory care; Asthma; Case studies; Childhood; Children & youth; Children's hospitals; Commissioning; Cost control; Departments; Expenditures; Gastroenteritis; Hospitals; Information centres; Innovations; Mathematical models; National health services; Nurse practitioners; Nurses; Paediatrics; Pediatrics; Routines; School attendance; Statistics; Studies; X-rays
• ISSN: 1477-7274; 2059-4631; 1758-6038; 2059-464X
• DOI: 10.1108/14777271311297948

Purpose - The purpose of this paper is to show how the new arrangements for commissioning services in the English NHS can facilitate innovations in service delivery leading to improvements in outcomes and cost effectiveness.Design methodology approach - The study uses cost modelling based upon the Hospital Episodes Statistics compiled by the NHS Information Centre to calculate recent expenditure upon treatment of routine childhood illnesses managed as short stay hospital admissions, and then uses a case study of a children's walk-in centre to show how an alternative service can be provided, and a new service embedded in general practice to show a further alternative type of provision.Findings - The study finds that large sums are currently being spent on inappropriate treatment of routine childhood conditions, especially in large urban conurbations. It demonstrates that in the case studies, the alternative provision can provide a viable and effective alternative.Research limitations implications - The research is based upon historical data by necessity. The new commissioning groups are not co-located with the historical PCTs on which this study is based. The data are collected by providers and co-ordinated by the NHS Information Centre. Therefore the investigators do not have control over the data quality. The second case study is a new service and therefore is used as an illustration of other service types.Practical implications - This study suggests that paediatric ambulatory services can be provided at lower cost with better outcomes.Social implications - This study provides the basis for a pilot study in Salford, where additional social benefits are targeted including better school attendance and increased self-awareness over child health amongst local families.Originality value - The study provides quantitative evidence for commissioning alternative paediatric ambulatory services.