Continuing Care Service – Turnaround

Financial restructuring of Continuing Health Care commissioning service and protocols.


Engaged by NHS Commissioner with “uncontrolled CHC expenditure” within private care homes and domiciliary sector.
Five individual CCG’s requirements channelled through one hosting commissioner.

Key Challenges

Five CCGs had recently been disaggregated from PCT and structures and strategy were in their infancy.
While commissioning team was established individual requirements and challenges of the separate CCGs were not clear.
Expenditure was out of control and visibility and reporting was limited.

Main Actions

Conducted rapid appraisal on assessment of CCH requests, the contracting process and overall management systems.
Developed cross-organisational turnaround plan and designed and implemented the structure across the five organisations.
Resourced and implemented a process for a reporting and assurance group.
Provided an expectation for the quantum for the level of savings and the ambition for the service performance.
Provided strategic support to the market management and contracting teams.
Provided ongoing critical friend role for Commissioning Leads and the Steering Group.

Main Results And Achievements

Implemented robust process for contracting, request appraisal and reporting for service delivery and budgets.
Ensured an escalated decision process was in place to ensure individual CCGs were approving the expenditure committed on their behalf.
Common commissioning demands agreed and overlaid with individual CCG requirements into detailed operating manual for contracting and assessment services.
Expenditure trajectory brought under control and in line with national and regional benchmarks.