Health Services

Health written question – answered on 4th March 2014.

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Photo of Jamie Reed Jamie Reed Shadow Minister (Health)

To ask the Secretary of State for Health

(1) how many commissioning access policies are being developed by NHS England; when they will be completed; and what rules apply to patient treatment pending their completion;

(2) how many NHS staff were assigned to specialised commissioning in (a) 2011-12, (b) 2012-13 and (c) 2013-14; and what level of expenditure they were responsible for in each such year;

(3) by what process and timetable commissioning access policies are developed and agreed when a treatment breaches the current maximum threshold of five individual funding requests in any one NHS England region.

Photo of Jane Ellison Jane Ellison The Parliamentary Under-Secretary of State for Health

As part of its role as direct commissioner, NHS England moved to a single operating model to support the commissioning of specialised services, which provided an opportunity to develop single national commissioning policies with the involvement of lead clinicians, patient representatives and other key stakeholders.

NHS England has 112 commissioning access policies in the pipeline for development, but this number is constantly changing. Established treatments that were routinely commissioned prior to 1 April 2013 will continue to be routinely commissioned. New treatments, or treatments not routinely commissioned prior to 1 April 2013, will not be routinely commissioned. National health service patients will not be able to receive these treatments, unless there are exceptional circumstances.

If the numbers of patients for whom the treatment is requested per year reaches five or more, the NHS England Area Team will treat this change as a service development requiring a commissioning policy. Guidance is available on the NHS England website at:

In April 2013, NHS England became the direct commissioner for specialised services and for 2013-14 expenditure for specialised commissioning is circa £13 billion.

In 2012-13 the level of expenditure identified as specialised commissioning was circa £7 billion, which was the responsibility of primary care trusts as the statutory responsible organisations.

NHS England advises that it is not possible to provide figures for staff assigned to specialised commissioning because they are not separately identified for- payroll purposes.

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