Making difficult choices: key issues in priority setting for clinical commissioners

This was a one-day workshop on priority setting for clinical commissioners held in partnership with the National Institute for Health and Clinical Excellence (NICE) and the National Association of Primary Care (NAPC). As clinical commissioning groups (formerly GP-led consortia) plan to take on responsibility for commissioning the majority of NHS services, this workshop offered an opportunity to explore the issues GPs and other clinicians will face when deciding which services and treatments to fund or not.

Using practical examples, the workshop explored four areas considered essential to robust decision-making about health funding priorities:

• The use of ethics to inform decision-making;
• The legal framework for priority setting;
• Public and patient involvement in priority setting;
• The lessons to be learned from primary care trust's (PCT's) experience of setting priorities for new and current investment.

The workshop was facilitated by Dr Judith Smith, Head of Policy at the Nuffield Trust, in a way that ensured the event was practically-focused and with plenty of opportunity for interactive discussion.

Speakers at the workshop were expert academics in the field of health services research, ethics and law, including:

• Professor Peter Littlejohns, Clinical and Public Health Director, NICE;
• Dr Johnny Marshall, GP and Chair, NAPC;
• Professor Christopher Newdick, Professor of Health Law, University of Reading;
• Dr Suzanne Robinson, Lecturer in Health Economics and Health care Policy, Health Services Management Centre (HSMC), University of Birmingham;
• Dr Mark Sheehan, Oxford Biomedical Research Centre Ethics Fellow, University of Oxford; member of Advisory Group for National Specialised Services (AGNSS) and Thames Valley Priorities Forum;
• Iestyn Williams, Lecturer, Health Services Management Centre (HSMC), University of Birmingham.

Practical case studies were also presented to allow participants to see what has worked on the ground. Participants were able to start to shape the development of their own clinical commissioning group's approach to priority setting as well as contributing to a broader debate on policy and practice about clinical commissioning in financially challenged times.