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27.07.16

NHS to trial specialised commissioning with four STPs

NHS England is trialling measures to ensure specialised services are delivered at a local level, according to a new report from its specialised services commissioning committee.

In the report, published ahead of NHS England’s board meeting tomorrow, the committee says that it is currently working to align development of its 2017-18 commissioning intentions with the 44 sustainability and transformation plans (STPs) currently being developed.

It says that it is currently working with four STPs – Greater Manchester, South East London, Cornwall and Herefordshire and Worcestershire – to demonstrate how the specialised services can be integrated into the footprints “within the legal constraints.”

The local footprints have now submitted their draft STPs for review by NHS England and NHS Improvement, although concerns have been raised about whether they can meet their goal of delivering sustainable integrated goals.

Manchester is also planning to integrate commissioning powers between its three CCGs and the city council.

The committee is also introducing a new strategic framework to better align the future direction of specialised services with the Five Year Forward View.

The framework is intended to support local level collaboration to make care more integrated and flexible.

The report says that these changes will require greater national support, including reform of clinical advice, improving data and information, support for innovation, and improving the prioritisation of new drugs and treatments.

The framework will also put in place new financial controls to provide incentives to reform care.

In addition, the committee is developing a collaborative commissioning programme, which is aimed at giving CCGs greater power over specialised commissioning.

It has established 10 collaborative commissioning hubs so far, which are being used to support the STPs.

Other reforms include a new decision-making methodology to support the Clinical Priorities Advisory Group in deciding which services should be supported by additional discretionary spend, and a service review programme to improve value for money of specialised commissioning.

The NHS has been heavily criticised for its spending on specialised services, which is set to grow by 7% this year, compared to 3.4% for the NHS as a whole.

The Public Accounts Committee has given NHS England until October to explain how specialised commissioning fits within the Five Year Forward View and how it is going to implement collaborative commissioning with CCGs.

In a recent interview with NHE, Dr Caroline Dollery, the chair of mid-Essex CCG, said that although she thought granting power over specialised commissioning to CCGs was “an improvement”, it should involve allowing CCGs to access the budget, skills and resources that NHS England uses at the moment.

The committee also said that it is now taking responsibility for overseeing the Cancer Drugs Fund investment group, which is being established as part of a reform of the fund to bring its finances under control.

However, NHS England’s specialised commissioning is currently facing uncertainty as it awaits the outcome of a legal challenge to its decision to stop commissioning the HIV prevention drug PrEP, which could affect its decisions on which services it can provide.

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