NHS Strategic Commissioning Framework — April 2026
From probable savings to commissioner-grade evidence to a closed NHS prevention loop
15 VCSE organisations · Cheshire West · Pilot cohort 2026
Performance
Productivity
Outcomes
Impact
Equity
Data Quality
Value for Money
Three evidence tiers
Tier 1 · Retrospective
Probable savings
NASP benchmarks applied to existing activity data. Estimated system savings before evidenced outcomes exist.
£127k
Estimated system saving
500+
People supported
20%
Prevention rate
View →
Tier 2 · Prospective
Evidenced outcomes
Actual WEMWBS scores, referral decisions, non-escalations. Documented at point of service. Commissioner-grade.
+8.4
Avg WEMWBS gain
73%
Non-escalation rate
312
Outcomes recorded
View →
Tier 3 · Referral Loop
Closed NHS loop
Enhanced Case Finding Tool cohorts referred into VCSE network. Outcomes tracked and reported back to Data into Action.
48
High-risk referrals
Q1
First report due
0
Mechanism existed
View →
Network headline KPIs
Orgs in pilot
15
of 375 CWVA members
↑ Target: 15–20
People supported
763
across pilot network
↑ Q1 2026
Data quality score
84%
field completeness
↑ from 41% baseline
Est. system saving
£127k
modelled · NASP rates
£4 : £1 NASP ratio
ICB 2026 evidence domain scores
Referral source breakdown
Tier 1 · Retrospective modelling
Probable system savings — early estimate
NASP benchmark rates applied to existing activity data. Not evidenced outcomes — a meaningful opening figure for the ICB conversation.
£127k
Estimated system saving · Q1 2026
People supported
763
across 15 pilot orgs
Prevention rate
20%
conservative NASP estimate
GP appts avoided
~153
@ £35 each = £5,355
A&E avoided
~61
@ £175 each = £10,675
NASP benchmark rates applied
Estimated saving by intervention type
NHS reference costs used in modelling
| Cost item | NHS unit cost | Estimated avoided | Estimated saving | Source |
|---|---|---|---|---|
| GP appointment | £30–40 | ~153 | £5,355 | NASP |
| A&E attendance | £150–200 | ~61 | £10,675 | NASP |
| CAMHS referral | £800+ | ~14 | £11,200 | Estimated |
| Inpatient admission | £2,500+ | ~5 | £12,500 | Estimated |
Tier 2 · Prospective outcome measurement
Commissioner-grade evidence — documented at point of service
Actual before-and-after WEMWBS scores. Actual referral decisions. Actual non-escalations. Not modelled approximations.
Avg WEMWBS gain
+8.4
baseline → exit
↑ Clinically significant
Non-escalation rate
73%
intervention resolved without NHS referral
Outcomes recorded
312
complete baseline + exit pairs
↑ 84% field completeness
Referrals avoided
228
documented non-escalation decisions
WEMWBS outcomes by organisation — baseline vs exit
| Organisation | People | Baseline score | Exit score | Gain | Status |
|---|---|---|---|---|---|
| Community drop-in A | 52 | 38.2 | 46.8 | +8.6 | Strong |
| Befriending service B | 41 | 35.4 | 43.1 | +7.7 | Strong |
| Food bank C | 67 | 32.1 | 41.5 | +9.4 | Strong |
| Social prescribing D | 38 | 40.3 | 47.9 | +7.6 | Good |
| Wellbeing hub E | 29 | 36.8 | 42.5 | +5.7 | Moderate |
Referral decision breakdown
Demographic completeness (equity domain)
Tier 3 · Referral loop closure
Closing the loop that currently doesn't exist
Enhanced Case Finding Tool cohorts → VCSE network → tracked outcomes → reported back to Data into Action. Done by their team, on their platform.
Mechanism existed before
None
Enhanced Case Finding Tool
Data into Action identifies high-risk individuals. 65+, frailty, LTCs, frequent A&E users.
→
VCSE network receives referral
Community support delivered. Quematics records intervention at point of service.
→
Quematics tracks outcomes
WEMWBS, referral decisions, non-escalations. Structured and aggregated.
→
Quarterly report to Data into Action
Structured Excel export. Aggregate anonymised cohort data. ICB-ready.
High-risk referrals in
48
from Enhanced Case Finding Tool
Interventions delivered
44
92% of referrals engaged
Hospital avoided
~31
estimated from cohort outcomes
Next report due
Q2
April–June 2026 · Excel export
High-risk cohort profile
WEMWBS outcomes — high-risk cohort
NHS Strategic Commissioning Framework — April 2026
The 2026 accountability shift — all 7 domains
The era of activity reporting has ended. Evidence now determines whether a contract is renewed, expanded, or put to competitive tender.
Performance
Who was served, how many sessions, attendance rate
82%
Productivity
Capacity utilisation, staff hours, cost per person
74%
Outcomes (PROMs)
WEMWBS baseline vs exit. Validated outcome measure.
68%
Impact
Non-escalations, avoided cost, system savings
71%
Equity
Demographic completeness. Deprivation reach.
59%
Data Quality
Field completeness across all 7 required fields
84%
Value for Money
£4:£1 NASP ratio. £127k estimated saving.
91%
Overall readiness
Across all 7 ICB evidence domains
76%
What happens without each domain — commissioner consequence
| Domain | Current score | Gap | Commissioner risk |
|---|---|---|---|
| Equity | 59% | Ethnicity field 71% complete | Review required |
| Outcomes (PROMs) | 68% | Exit WEMWBS 79% captured | Strengthen evidence |
| Impact | 71% | Non-escalation recording improving | On track |
| Productivity | 74% | Cost per person not yet fully costed | On track |
| Performance | 82% | Strong. Session data complete. | Strong |
| Data Quality | 84% | Up from 41% at baseline | Strong |
| Value for Money | 91% | £4:£1 NASP modelled return | Strongest domain |
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CWVA Prevention Evidence Intelligence
Live · Pilot 2026
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