The Year of Care commissioning model for long term conditions

The Year of Care pilots were charged with delivering both personalised care planning in routine practice and new ‘non – traditional’ services to support self management (SSM), at a time of diminishing funds. They were forced to rethink the principles and practice of service redesign across the whole local diabetes community. The outcome was a model which addresses these issues as an exemplar for other LTCs. 

This model describes the components of care from a functional rather than an organisational perspective. The commissioner is challenged to think about spending a finite resource on the basis of three broad categories of care – traditional biomedical / clinical care, care to support self management within the institutional health service, and care to support self management in the wider community or at home. This is instead of considering only the traditional health service organisations within secondary, primary and ‘community’ care.  

This not only throws the decisions that need to be made into sharper focus for both the clinician and the finance director, but opens up a much wider range of solutions during the process of service redesign. It also gives greater legitimacy to the claims for other important services supporting self management, during those discussions.

Year of care commissioning model for long term conditions

The model made it easier for pilots to see where redesign would not only improve quality but also lead to savings; it highlighted the current barriers to commissioning for LTCs and demonstrated how these could be addressed in the new commissioning landscape.

Read more about this model and the barriers and potential enablers in Chapter 16 (PDF 1.1MB) and Workforce issues and service planning for people with Long Term Conditions (Word 582KB).