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Outcomes Based Commissioning

Outcomes Based Contracting for Mental Health-OCCG-GB briefing

What are we doing?

Following discussions and feedback from patients, the public and our partners in health and social care Oxfordshire Clinical Commissioning Group (OCCG) has been progressing a new form of contract to deliver improved outcomes for patients and greater financial stability for the health economy called outcomes based contracting (OBC – previously outcomes based commissioning). It is supported by NHS England and is being adopted by a growing number of CGGs.

By adopting OBC, the success of healthcare provision will be measured by results that matter to the patient not by numbers of patients seen. Patients will have more influence over how their healthcare is delivered by helping to shape the outcomes that are included in the contracts and by making informed decisions about how their care is delivered.

Following a pause in the progression of OBC in Oxfordshire during which time an NHS Gateway Review* was undertaken, phase 3 of the project has commenced and will see OBC being developed and enacted for Older People’s Services and Mental Health. At this time Maternity Care will not be taken forward as part of the OBC.


Why are we doing it and what will it mean for you?

 The NHS is facing unprecedented challenges to its sustainability – demographic change, increasing demand, and pressure on resources. We are experiencing this in Oxfordshire and have a responsibility to act to deliver better value and outcomes for patients. A move to OBC will help to achieve this.

The issues Facing Mental Health and Older People’s Services in Oxfordshire are outlined below:

Older People Mental Health
  • Over 65s with a life limiting Long Term condition increase by 22% by 2020
  • Over 65s with Dementia increase by 28% by 2020
  • Older population will increase by 2.5% per annum over the next 5 years which will lead to a cost increase of c£18.2m over the next 4 years.
  • Currently 22 individual contract that cover over 65s in Oxfordshire
  • Demand increasing greater than population growth
  • 11.9% of the population has depression
  • OCCG is an outlier on spend within mental health spending £235 per head per year
  • Currently 10 contracts with providers for mental health services
  • Identification of £13m savings to close the financial gap and to support efficiencies
  • Demand increasing greater than population growth.


Below are the outcomes we are working towards aligning the services that are provided:

Mental Health Older People
People will live longer As an older person or a carer, I want to be helped to be healthy and active
People will improve their level of functioning As an older person or carer, I want to be helped to be as independent as possible in the best place for me
People will receive timely access to assessment and support As an older person or carer, I want to be helped to be as independent as possible in the best place for me and when I am in need or care, it is safe and effective
Carers feel supported in their caring role As an older person or carer, I want to be helped to be as independent as possible in the best place for me and have a good experience and treated with respect and dignity
People will maintain a role that is meaningful to them
People continue to live in settled accommodation
People will have less physical health problems related to their mental health


Organisations that provide healthcare across Oxfordshire will need to work together to deliver those patient led outcomes, and will be rewarded based on the on-going improvements in health, support and patient experience.

Adopting OBC will mean that:

  • Patients will no longer have to navigate an uncoordinated fragmented system
  • Funding will be linked to the achievement of outcomes, rather than activity and processes.
  • There will be more freedom to design services to suit the needs of patients, under a single contract, with fewer process targets
  • There will be better planned care packages for the patient to reduce number of visits and time in hospital
  • The patient’s journey through the health and social care system will be provided by a ‘case coordinator’ employed by the provider
  • By sharing data on patients with GPS there will be transparency in reporting on whether over time, patients are getting better treatment and the outcomes measures are being met
  • There will be continual improvement for patients


What will happen next?

 Whilst we will be getting on with developing and agreeing the new contracts with our providers Oxford Health NHS Foundation Trust and Oxford University Hospitals NHS Trust, we may need your input and ideas along the way in order to achieve our goals.


June 2014

For mental health,agree an outcomes based contract in dialogue with Oxford Health and voluntary sector providers. This will include development of a single contract for the services and delivery of outcomes.

September 2014

For older people, agree an outcomes based single contract with Oxford Health and Oxford University Hospitals focused on the acute assessment/admission and discharge/reablement pathway. This will be undertaken in conjunction with Oxfordshire County Council.


To keep up to date with the work outlined above and to get involved please register on the CCG’s Talking Health, online consultation system, so we can speak to you about the OBC and seek your feedback:


* An NHS Gateway Review is a process that provides all NHS and other health public sector organisations with free and confidential independent peer review support for their projects and programmes. Supported by the Cabinet Office and managed by a dedicated team in the Department of Health, Health Gateway Reviews provide assurance to programme and project owners that their project is on course to deliver the desired outcomes, on time and within budget.

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