User involvement is central to outcome-based commissioning

Description

This presentation argued that effective commissioning requires genuine user engagement from the outset, not tokenistic involvement added later. The talk contrasted services that hit targets with those that miss people's actual needs, staff often rate user involvement at 7-8 whilst service users rate it 0-5, suggesting the term means different things to different groups.
Two commissioning failures in Northern Ireland were examined. Paediatric Type 1 Diabetes care shows significant inequity, despite NICE guidance recommending hybrid closed-loop systems for all ages, access in NI remains limited compared to 75% coverage in NHS England, creating a £1000s annual burden on families. The DiRECT Diabetes RemissionClinical Trial is being piloted but not yet commissioned regionally, whilst England rolled it out nationally. NI spends £162 million annually managing diabetes complications.
Analysis of the NIDoc Dialovelies WhatsApp group (210 members) revealed how community resilience fills gaps when services fail, providing emotional, informational, and practical support with 24-minute response times during evenings when formal services are closed. The talk concluded by advocating for person-reported outcome measures co-designed with people living with diabetes, embedding service users as co-evaluators rather than just recipients.

Period	1 Sept 2025 → 30 Sept 2025
Held at	Governance International, United Kingdom