The commissioning and benchmarking tool
Use the paediatric continence service commissioning and benchmarking tool to determine the level of service that might be needed locally and to calculate the cost of commissioning the service, as described below.
Identify indicative local service requirements
The indicative benchmark rate for a paediatric continence service is 0.8% or 800 per 100,000 population aged 19 years and under.
The commissioning and benchmarking tool helps you to assess local service requirements using the indicative benchmark as a starting point. With knowledge of your local population and its demographic, you can amend the benchmark to better reflect your local circumstances. For example, if your population is significantly younger than the average population, or has a significantly higher or lower rate of paediatric continence problems, you may need to provide services for relatively more or fewer children and young people.
Review current commissioned activity
You may already commission a paediatric continence service for your population, which may include referrals and admissions to paediatricians in secondary care. It is estimated that establishing a paediatric continence service for children and young people aged 19 years and under could lead to up to an 80% reduction in the number of emergency admissions to secondary care, by providing assessment and management of continence problems in primary and community settings.
The commissioning and benchmarking tool provides tables that allow you to calculate the potential savings associated with a reduction in the number of emergency admissions, elective admissions and outpatient appointments in secondary care for the specialist assessment and treatment of continence problems.
It is anticipated that there may be an increase in the prescription costs for oral medication for constipation, including polyethylene glycol 3350 (Movicol), in primary care. However, it is also anticipated that these costs will be more than offset by a corresponding reduction in the number of inpatient spells and outpatient attendances for children and young people with constipation, as early treatment will prevent the problem from becoming a chronic condition.
There is also the potential to reduce costs further by reducing the demand for continence products such as nappies or pads. These cost savings may be possible through investment in a paediatric continence service using a primary or community care model.
The potential for cost savings is examined further in the commissioning and benchmarking tool.
Identify future change in capacity required
Using the indicative benchmark provided, or your own local benchmark, you can use the commissioning and benchmarking tool to compare the activity that you might need to commission against your current commissioned activity. This will help you to identify the future change in capacity required. Depending on your assessment, your future provision may need to be increased or decreased.
Model future commissioning intentions and associated costs
You can use the commissioning and benchmarking tool to calculate the capacity and resources needed to move towards the benchmark level, and to model the required changes over a period of 4 years.
Use the tool to calculate any potential savings that may be associated with a reduction in secondary care activity over a 4-year period, and to model the appropriate investment that may be needed in a paediatric continence service to allow these savings to be realised. You may need to consider the settings in which the paediatric continence service may be provided. The tool is pre-populated with data on the potential recurrent and non-recurrent cost elements that may need to be considered in future service planning, which can be reviewed and amended to better reflect your local circumstances.
Commissioning decisions should consider both the clinical and economic viability of the service, and take into account the views of local people. Commissioning plans should also take into account the costs of monitoring the quality of the services commissioned.
This page was last updated: 02 March 2012