Health Services

Department of Health and Social Care written question – answered at on 16 May 2024.

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Photo of Karin Smyth Karin Smyth Shadow Minister (Health)

To ask the Secretary of State for Health and Social Care, what assessment she has made of the potential impact of joint commissioning on the 59 specialised services approved by the NHS England Board in February 2023.

Photo of Karin Smyth Karin Smyth Shadow Minister (Health)

To ask the Secretary of State for Health and Social Care, with reference to Annex A of the NHS publication entitled Specialised Commissioning – update on specialised services for delegation, published on 28 March 2024, whether she plans for the 32 specialised services retained by NHS England from April 2025 to be (a) delegated or (b) retained in perpetuity.

Photo of Karin Smyth Karin Smyth Shadow Minister (Health)

To ask the Secretary of State for Health and Social Care, what assessment she has made of the potential imapct of delegating specialised services to Integrated Care Systems on continuity of care for patients.

Photo of Karin Smyth Karin Smyth Shadow Minister (Health)

To ask the Secretary of State for Health and Social Care, what assessment she has made of the potential impact of delegating specialised services to Integrated Care Systems on patient outcomes.

Photo of Karin Smyth Karin Smyth Shadow Minister (Health)

To ask the Secretary of State for Health and Social Care, what engagement commissioning hub teams looking at specialised commissioning have with commissioning support units.

Photo of Helen Whately Helen Whately Minister of State (Department of Health and Social Care)

The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between integrated care boards (ICBs) and NHS England regional teams, followed by a National Moderation Panel and final decision taken by the NHS England Board. The NHS England Board papers for February 2023, December 2023, and March 2024 are available respectively at the following links:

https://www.england.nhs.uk/wp-content/uploads/2023/02/board-2-feb-23-item-7-delegation-of-spec-comm.pdf

https://www.england.nhs.uk/long-read/specialised-commissioning-2024-25-next-steps-with-delegation-to-integrated-care-boards/

https://www.england.nhs.uk/long-read/specialised-commissioning-update-on-specialised-services-for-delegation/

The process concluded that a transitional year of joint commissioning would offer the most secure and stable transition towards delegation. NHS England is working alongside ICBs to ensure that delegation agreements are in place, including ensuring appropriate collaborative arrangements are developed to support ICB commissioning of specialised services. These arrangements will be monitored by NHS England through its assurance processes for specialised services.

On 28 March 2024, the NHS England Board approved the recommendation that the 32 specialised services listed in Annex A of Item 7 of Specialised Commissioning: update on specialised services for delegation, would be retained by NHS England.

Regardless of delegation status, NHS England will remain the accountable commissioner for the entire portfolio of specialised services, and as part of this role, will monitor the effectiveness of delegation and the lists of services. It should be noted that NHS England does have the ability to bring a service back under national commissioning control, under the safeguards put in place to support delegation.

All specialised services, whether retained or delegated, must comply with nationally developed standards, including service specifications and clinical commissioning polices. ICBs will be able to use specialised services funding to transform and develop services and pathways across their core and specialised responsibilities, to improve quality of care and equity of access and value, whilst also complying with national standards.

Whilst delegation is not an end in itself, moving to ICB-led commissioning supports a focus on population health management across whole pathways of care, and gives ICBs the powers they need to improve the quality of services, tackle health inequalities, and ensure best value. NHS England set out in detail the benefits of greater ICB involvement in the commissioning of appropriate specialised services in the Roadmap for Integrating Specialised Services within Integrated Care Systems, and subsequent board papers. This roadmap is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2022/05/PAR1440-specialised-commissioning-roadmap-addendum-may-2022.pdf

These plans have been developed in close collaboration with NHS England’s regional teams, ICBs, specialised service providers, clinicians, and patients, and represent the outcome of a thorough assessment of ICB system readiness, and a comprehensive analysis of services to determine their suitability and readiness for more integrated commissioning. During 2024/25, specialised services commissioning teams will remain employed by NHS England. NHS England has a framework for commissioning support, and accesses a range of services from commissioning support units. For example, data and business intelligence, and programme and project management expertise and resources.

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