Creating Sustainable Frameworks for Service Redesign at Practice Level in the NHS

The National Health Service (NHS) in England is pursuing a programme of transformation through innovation, aiming to ‘provide High Quality Care for All in an NHS fit for 21st century and beyond’. Practice Based Commissioning (PBC) is one key strategy, devolving responsibility for commissioning of health services from Primary Care Trusts (PCTs) to front-line clinicians in General Practice (GPs). Focusing on developments in the North West Strategic Health Authority (NW SHA), this paper discusses the means by which varying structures of PBC governance afford scope and support for sustainable innovation at practice level.
Preliminary results from a project with one large GP practice in NW SHA investigating the application of design methods to issues of patient engagement and the redesign of care pathways are discussed, as is the necessity of reinterpreting and adapting these tools to ensure that clinicians and practice managers can appropriate and apply them in daily practice.