Glossary of common terms

Below is a glossary of common terms that you may come across as you begin the process of commissioning.  Familiarising yourself with these will help you navigate the commissioning structures in your area and present the Reading Friends offer in a confident and compelling manner.

Clinical Commissioning Groups – CCGs are groups of GPs that are responsible for designing local health services in England. They do this by commissioning or buying the health and care services that their local population need. CCGs work with patients and healthcare professionals and in partnership with local communities and local authorities.

• The Scottish NHS consists of 14 regional Health Boards, covering all of Scotland. They take the role roughly equivalent to CCGs in England, in that they plan and deliver health services based on the needs of the local community.
• In Wales, GP-led neighbourhood community networks feed views on service design back to their local health board. The Local Health Boards (LHBs) develop and provide health services much like CCGs in England. There are seven LHBs to cover Welsh regions.
• In Northern Ireland the Health and Social Care Board (HSCB) is responsible for assessing health and social care needs and commissioning services. Its role is broadly equivalent to CCGs in England, and Health Boards in Scotland and Wales, but as well as commissioning health services it is also responsible for social services. The HSCB has five Local Commissioning Groups.

Co-creation or co-production – This is where the customer or client and professionals design the service together in a more equal relationship. 

Commissioning – The strategic activity of identifying need, allocating resources and procuring a provider to best meet that need, within the available means.

Contract – A mutual agreement enforceable by law.

Contracting – The process of negotiating and agreeing the terms of a contract for services, and on-going management of the contract including payment and monitoring.

Decommissioning – The process of planning and managing a reduction in service activity or terminating a contract in line with commissioning objectives.

Direct payments – Budgets paid directly to social care users to meet their needs. They are a form of personal budgets, giving service users direct control of the money allocated to them for care.

Director of Public Health (DPH) – Are appointed through councils and Public Health England acting jointly.  The role of the director of public health is to champion health, promote healthier lifestyles. These statutory chief officers also contribute to the preparation of the Joint Strategic Needs Assessment (JSNA) and the annual Joint Health and Wellbeing Strategy (JHWS).  There is a director of public health for each upper tier local authority, although one DPH may cover more than one council.

European Union (EU) Procurement Directives – The EU Procurement Directives set out the law on public sector procurement. Along with the EU treaty principles, and relevant case law from the European Court of Justice, their purpose is to open up the public procurement market and to ensure the free movement of goods and services within the EU.

Health and Wellbeing Board (HWB) – A statutory committee at upper tier or unitary level in England that leads and advises on work to improve health and reduce health inequalities amongst the local population.  HWBs were created by the Health and Social Care Act 2012, and have been given the statutory responsibility of encouraging integrated working between health and social care commissioners, and of preparing a JSNA and a JHWS.  Members include councillors, GPs, health and social care officers and representatives of patients and the public.

Health inequalities – Are differences in health experienced by different groups in a community which are avoidable and therefore held to be unacceptable.

The Index of Multiple Deprivation – A UK wide qualitative study of deprived areas. The statistics cover seven aspects of deprivation: income, employment, health deprivation and disability; education skills and training, barriers to housing and services, crime, living environment.

Integrated Care Systems – In an integrated care system, NHS organisations, in partnership with local councils and others, take collective responsibility for managing resources, delivering NHS standards, and improving the health of the population. By working alongside councils, and drawing on the expertise of others such as local charities and community groups, the NHS can help people to live healthier lives for longer, and to stay out of hospital when they do not need to be there.

Integration Authorities – 31 Integration Authorities across Scotland are working with their local communities and providers of care to ensure care is responsive to people’s health and social care needs. Each Integration Authority is required to publish an annual performance report, which will set out how they are improving the National Health and Wellbeing Outcomes.

Joint commissioning – The process in which two or more organisations act together to coordinate the commissioning of services, taking joint responsibility for the translation of strategy into action.

Joint purchasing – Two or more agencies coordinating the actual buying of services, generally within the context of joint commissioning

Joint Strategic Needs Assessment (JSNA) – The process and document(s) through which local authorities, the NHS, service-users and the community and voluntary sector in England research and agree a comprehensive local picture of health and wellbeing needs. The development of JSNAs is the responsibility of Clinical Commissioning Groups (CCG) and councils through HWBs.

Joint Health and Wellbeing Strategy (JHWS) – Health and wellbeing boards in England are required to produce an annual JHWS for the local area, based on the needs identified by the JSNA. This document sets out the jointly agreed priorities upon which commissioning plans are based.

Local Commissioning Groups (LCGs) – In Northern Ireland there are 5 LCGs responsible for the commissioning of health and social care by addressing the care needs of their local population. They also have responsibility for assessing health and social care needs; planning health and social care to meet current and emerging needs; and securing the delivery of health and social care to meet assessed needs.

National Institute for Health and Clinical Excellence (NICE) – The body responsible for providing research, evidence and guidance on what medication, treatments and interventions should be available through the NHS and, in the case of public health, through local authorities.

Outcomes Framework – A framework that sets out the outcomes and corresponding indicators against which achievements can be measured.

Outcomes-focused approach – An approach based on focusing on the results rather than on the outputs of investing in a service or providing it in a certain way.  Commissioners can be clearer about the real benefits they are seeking by defining the outcomes being sought in terms of improved health and wellbeing.

Personalised budgets – Are an allocation of funding given to users after an assessment, which should be sufficient to meet their assessed needs. Users can either take their personal budget as a direct payment, or leave councils with the responsibility to commission the services. Or they can have some combination of the two.

Personalisation – The principle refers to the process of providing individualised, flexible care that is intended to promote the independence of those who need care. Think Local Act Personal is a national partnership committed to transforming health and care through personalization and community based support.

Pooled budgets – A mechanism for commissioning partners to bring money together in a separate fund, to pay for agreed services.

Primary prevention – A program of activities directed at improving general well-being while also involving specific protection for selected diseases, such as immunisation against measles.

Procurement – The process of identifying and selecting a provider that may involve competitive tendering.

Providers – Any person, group of people or organisation supplying goods or services. Providers may be in the statutory or non-statutory sectors.

Public Service Boards (PSBs) – The vehicle through which leaders of local public and third sector organisations in Wales come together to develop an integrated plan for each area. Each board must carry out a well-being assessment and publish an annual local well-being plan. The plan sets out how they will meet their responsibilities under the Wellbeing of Future Generations (Wales) Act. 

Ring-fenced budgets (for public health) – Public health budgets allocated to English councils for their role in public health.  Although a limited number of services are mandatory, councils can use the ring-fenced budget widely to improve public health in their local area in line with local priorities. This may include using it jointly with other council budgets such as those for children’s service, schools, housing, transport and environmental health.

Secondary prevention – A level of preventive medicine or activities which focus on early diagnosis, use of referral services, and rapid initiation of treatment to stop the progress of disease or a disability. Secondary prevention is also sometimes referred to as ‘re-ablement’ and is used to help people who have experienced a fall, stroke or bereavement, to be rehabilitated and maintain independence.

Sustainability and Transformation partnerships (STPs) – STPs were created to bring local health and care leaders together to plan around the long-term needs of local communities.  There are 44 STPs in England formed by NHS organisations and local councils and a number of these partnerships have now grown into integrated care systems.

Theory of Change – A description and illustration of how and why a desired change is expected to happen in a particular context. It is focused on mapping out what a programme or change initiative does (its activities or interventions) and how these lead to desired goals being achieved. It does this by identifying the desired long-term goals and then identifies all the conditions (outcomes) that must be in place (and how these related to one another causally) for the goals to occur. These are all mapped out in an Outcomes Framework.

Transformational change – Is change that is not merely an extension or improvement over the past. It involves discontinuity, a shift in assumptions and a willingness to work with complexity. Transformational change requires a shift in mind-set, behaviour and ways of working.

Wellbeing – Used by the World Health Organisation (1946) in its definition of health as “a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity”. More recently the concept was described as “feeling good and functioning well” (New Economics Foundation, 2008). Creating wellbeing (of which good physical health is a component) requires the mobilisation of the widest assets to ensure community cohesion, safety etc.