NHS finance

Question 1

How does NHS commissioning work? (6)

Answer 1

NHS commissioning definition states “Commissioning in the NHS is the process of ensuring that the health and care services that are being provided meet the needs of the population”

• It is a complex process with responsibilities ranging from assessing population needs, prioritising health outcomes, planning and agreeing the services, procuring and monitoring service providers.
• Funding relies on national and Regional budget’s allocated by the government to each integrated care boards (IBGs).
• Within each region, the budget is further allocated to individual hospitals and healthcare trusts.
• Within each hospital or trust, budgets are then allocated to various departments, including dietetic services.
• Dietetic departments may need to submit proposals or business cases to justify their budget requests using needs assessments and plans for service delivery improvements.

Question 2

What six things are covered in a dietetic service budget?

Answer 2

• staffing costs (largest portion)
• training and development
• patient resources
• equipment and technology
• research and development
• contingency funds

Question 3

What is the importance of long term planning?

Answer 3

in the context of NHS England 2022 and the NHS Long Term Plan of 2019, is significant for several reasons:

1. National Health Goals: Align with the goals set out in the NHS long term plan 2019 ensuring dietetic services are being provided which meet the needs of the population.
2. Integrated care systems, advocated by the NHS long term plan 2019, allows for the clear development of outcomes, which allow safe, effective and good quality care in our practice as HCPC registered dietitians.
3. Sustainability : Additionally, short-term fixes that were introduced to manage the NHS’ finances are not sustainable. A forward-looking approach is critical for ensuring that dietetic services continue to be expanded and are financially viable in order for the NHS to be sustainable and available for further generations.

Question 4

What are the 10 sections required for a business plan for a home enteral dietitian funding application?

Answer 4

Section 1: Executive Summary
Section 2: Current Service
Section 3: Reason for Change
Section 4: Description of Proposal
Section 5: Option Appraisal
Section 6: Financial Summary
Section 7: Quantitative Effect on Service
Section 8: Specification on Impact on Other Services
Section 9: Project Plan
Section 10: Benefits Realisation and Next Steps

Question 5

What should go in the exec summary?

Answer 5

Section 1: Executive Summary

• Overview of the proposal for a home enteral feed dietitian.
• Highlight the expected outcomes and benefits for patient care.

Question 6

Section 2: Current service

Answer 6

Description of the existing enteral feeding services within the NHS.
*Analysis of gaps or limitations in current services, particularly in the community setting.

Question 7

Section 3: reason for change

Answer 7

Evidence of the need for enhanced community-based enteral feeding support.
* Data on patient outcomes, hospital readmissions and A&E adm

Question 8

Section 4: description for proposal

Answer 8

Detailed outline of the proposed home enteral feed dietitian role (fixed term contract)
* Description of patient demographics (need) and service operation methodology.
* Integration with existing healthcare services.

Question 9

Section 5: Option appraisal

Answer 9

Analysis of different approaches to providing enteral feeding support in the community
* Comparison of the proposed service with alternative solutions, considering effectiveness and feasibility.
* comparing to NHS planning framework and NICE guidelines and local guidelines

Question 10

Section 6: Financial summary

Answer 10

• Detailed budget including setup costs, operational expenses, and funding sources.
• Cost-benefit analysis showcasing potential savings or value addition to the NHS.

Question 11

Section 7: Quantitative effect on service

Answer 11

• Projected impact on patient numbers, service efficiency, and resource utilisation.
• Expected improvements in patient health outcomes and service delivery metrics.

Question 12

Section 8: Specification on Impact on Other Services

Answer 12

• Analysis of how the new service will interact with and impact existing healthcare services.
• Potential benefits to other services, such as reduced hospital admissions.

Question 13

Section 9: Project Plan

Answer 13

Timeline and key milestones for implementing the new service.
* Plans for recruitment, training, and logistical setup.

Question 14

Section 10: Benefits Realisation and Next Steps

Answer 14

Strategies for measuring and realising the benefits of the new service.
* Key performance indicators and follow-up plans for continuous improvement.
* Next steps for securing funding and initiating the project.