Next steps on the Clinical Advisory Group’s recommendations for specialised services

The Secretary of State for Health is to consult with the NHS Commissioning Board Authority on the recommendations of the Clinical Advisory Group for Prescribed Services for the commissioning of specialised health services.

The Department of Health has announced that Ministers have accepted in full the recommendations of the advisory group and published its report on its website on 11 September 2012. The report recommends which health services for treating people with rare and uncommon conditions should be nationally commissioned from April 2013. Following the consultation, a set of Parliamentary regulations will be published that will specify the services to be commissioned. The publication of the regulations is subject to the Parliamentary timetable. The NHS Commissioning Board (NHS CB) – as it will be from 1 October 2012 – will implement the regulations through its direct commissioning of specialised health services.

The advisory group considered whether the Specialised Services National Definitions Set – which was the subject of a full review in 2009-10, as a result of the recommendations of the Carter Review of 2006 – should be commissioned by CCGs or by the NHS CB.

The advisory group concluded that virtually all those specialised services currently commissioned by specialised commissioning groups and the National Specialised Commissioning Team were appropriate for the NHS CB to directly commission. The advisory group also recommended that some of the definitions should be clarified to better define the specialised elements that will be commissioned by the NHS CB. In addition it identified some services that are more appropriately commissioned at a local level by CCGs and others that should be commissioned nationally.

The advisory group – whose membership included GPs and senior hospital doctors – took advice from 60 expert clinical reference groups, each representing a different specialised service area. The clinical reference groups have a multi-disciplinary membership that includes clinicians, commissioners and patient group representatives.

Specialised services – which account for over £11 billion, or 10 per cent of the entire NHS budget – will become the responsibility of the NHS CB from April 2013. This is to ensure that individual CCGs do not have to fund unpredictable and sometimes expensive treatments. Nationally consistent service specifications and policies will be developed for each of the services that the NHS CB will commission.

The Board Authority is currently developing a single operating model for the
commissioning of specialised services to ensure there is increased efficiency and consistency around the planning and delivery of high quality specialised services for patients across England. Under this operating model, CCGs and the NHS CB will work closely together to ensure there is no division of care where different elements of the patient pathway are commissioned by different bodies. The operating model is due to be published in the next few weeks.

For further information, please see the frequently asked questions document.

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