The NHS Commissioning Board (NHS CB) today pledges to drive a revolution for patients, offering the public more information about quality of care and giving them greater control of their health.
Publishing its planning guidance for 2013/14, the NHS CB aims to help local clinicians deliver more responsive health services, focused on improving outcomes for patients, addressing local priorities and meeting the rights people have under the NHS Constitution.
Called Everyone Counts: Planning for Patients 2013/14, the document outlines the incentives and levers that will be used to improve services from April 2013, the first year of the new NHS where improvement is driven by clinical commissioners. It also addresses health inequalities, so that those most in need gain the most from the support we provide.
The guidance covers a clear set of outcomes against which to measure improvements and outlines five offers: moves toward seven-day a week working for routine NHS services; greater transparency and choice for patients; more patient participation; better data to support the drive to improve services: and higher standards and safer care.
To assist those planning services locally, the NHS Commissioning Board also today publishes comparative information on outcomes for patients in all CCG and local authority areas. These outcomes benchmarking packs are intended to support the local planning of health and care.
As the NHS CB continues to prepare to take on its full powers from 1 April 2013, overseeing expenditure of England’s £95.6 billion NHS budget to deliver the Government’s mandate, it also publishes today the financial allocations for CCGs and for the NHS CB for 2013/14. Within this overall funding, the NHS CB has allocated £63.4 billion to CCGs. This represents 2.3% growth compared to the equivalent 2012/13 baselines – a real terms increase of 0.3% at a time of limited resources which, working with local Health and Wellbeing partners, CCGs will use to ensure improved service quality and better health outcomes for their patients and communities.
The NHS CB will commission some services nationally for the first time, improving them by tackling variation in care around the country. These services include specialised healthcare, primary care and services for the military as well as those in prison and offenders with otherwise-reduced liberty. The budget of £25.4 billion set for these services also represents a 2.6 per cent increase over the equivalent activities in 2012/13.
The NHS CB is also initiating a review of the approach to allocations to give the best opportunity to improve outcomes for patients and tackle health inequalities.
Sir David Nicholson, the NHS Commissioning Board’s Chief Executive, said: “The NHS can be justly proud of its achievements. People wait less, they are diagnosed and referred quicker and our hospitals have fewer infections. But everyone in the NHS knows we must continue to improve.
“There are big challenges – not least the financial backdrop – but we must be ambitious. We want to make the NHS the best customer service in the world by doing more to put patients in the driving seat. We are determined to focus on outcomes and the rights people have under the NHS Constitution, as well as ensure those most in need gain most from the support we provide.
“At the heart of our approach is local control over decision making. We want to put power in the hands of clinicians who know their patients best. We want to give them the money, information and tools to do the job. And we want the public to have the information they need to make choices and participate fully in the development of their health services.”
Comments on this page are now closed.
‘Everyone counts’ – pleasant sound bite, but what will the Commissioning Board actually do to change the present system of compartmentalised services, that avoid any overall responsibility for patient care.
I would suggest that the Commissioning Board take a look at the tortuous individual complaints procedures and bring in one place for the patient to go to raise a complaint,.
Hi
Thank you for your comment. We are in the process of developing how the NHS Commissioning Board will deliver key functions such as customer contact, which would include complaints and the necessary resources. The NHS CB is also working on a new integrated customer service platform, which will be a way for the public to engage with the NHS using a wide range of channels, including telephone, web, apps and social media.
Kind regards
Simon
Digital Communications Officer
NHS Commissioning Board
In Gloucestershire it scares me to see the 20% per annum rise in NHS Outcomes Framework indicator 1.5 (Excess under 75 mortality rate in adults with serious mental illness). It scares me even more to see indicator 1.5 omitted from these packs. The LA-level pack doesn’t mention mental health at all. When word gets around that the NHS CB hides things it finds difficult, who will trust anything it says?
Hi Rod
Thank you for your query. We have included any indicators within the clinical commissioning group (CCG) packs where data is available and considered robust at CCG level. In terms of indicator 1.5, this is not yet available at CCG level but we understand should become available in the future.
In the local authority packs, we included only overarching indicators from the NHS, public health and adult social care Outcomes Frameworks. Whilst this means that indicator 1.5 wasn’t included, as it isn’t an overarching indicator, mental health mortality is captured within both the NHS and public health overarching measures of life expectancy and healthy life expectancy.
Kind regards
Simon
Digital Communications Officer
NHS Commissioning Board
Are individual local authority allocations for the £0.9bn transfer from the NHS to LAs, to fund services that benefit both health and social care, published on the website anywhere? Thank you.
Hi
Thank you for your comment. This is due to be published shortly, once it has been I’ll update this response with the link.
Kind regards
Simon
Digital Communications Officer
NHS Commissioning Board
Am I right to assume that (a) the Advisory Committee on Resource Allocation has proposed a new funding formula and (b) the Commissioning Board has rejected it?
Hi David
Thank you for your comment. The NHS Commissioning Board has concluded that the formula proposed by the Advisory Committee on Resource Allocation (ACRA) accurately predicts the future spending requirements of CCGs based on the pattern of need as it is being met from that particular budget.
However, it is concerned that use of the formula on its own to redistribute funding would predominantly have resulted in higher growth for areas that already have the best health outcomes compared to those with the worst. On the face of it, this appears inconsistent with the NHS Commissioning Board’s public purpose to improve health outcomes for all patients and citizens and reduce health inequalities.
It will therefore conduct an urgent, fundamental review of the approach to allocations, drawing on the expert advice of ACRA and involving all partners whose functions impact on outcomes and inequalities. It will be completed in time for initial conclusions to inform 2014/15 allocations.
In the mean time, it has opted for an above real terms uniform increase in funding to all CCGs that will give these new organisations stability in their first year.
Kind regards
Simon
Digital Communications Officer
NHS Commissioning Board
Hi Simon
(a) Is there an official statement on the website or in a document about the decision not to use the formula recommended by ACRA ?
(b) Did the formula not include a health inequalities component, as used previously for PCT allocations, which can be designed to allow for unmet need ?
(c) Will the review involve consultation with CCGs and local authorities ?
Hi John
Thank you for your questions. The Board has concluded that ACRA’s formula is a robust reflection of the future spending requirements of local communities based on the pattern of need, as it is being met currently. However, ACRA itself recognised in its report to the Secretary of State that further work was required to improve the treatment of areas where deprivation and other factors currently lead to suboptimal use of services. These are complicated and challenging issues, and on balance we have decided that it would be inappropriate to proceed with allocations based on the new formula until we have completed a thorough review of the potential to achieve more holistic allocation approaches. This review, involving all partners whose functions impact on outcomes and inequalities, will be completed in time to inform decisions on allocations for 2014/15.
We want to take advice from our expert group, ACRA, in working with our partners across the health and care system with the aim of achieving an approach to allocations that supports improved outcomes and reducing inequalities. We want to be able to take account of all funding that has an impact, for example primary care and preventative services.
In the mean time, it has opted for an above real terms uniform increase in funding to all CCGs that will give these new organisations stability in their first year.
Hope that helps, kind regards
Simon
Digital Communications Officer
NHS Commissioning Board
Thank you Simon for the further detail on the decision not to use ACRA’s recommendation on allocations.
Just a couple of further queries:
(a) I’m still not totally clear on your answer to question (c).
(b) Is ACRA’s report to the Secretary of State available ?
Hi John
Thank you for your questions. The review will include CCGs and local authorities as their functions impact on outcomes and inequalities. The ACRA report, presented to the Secretary of State, and is due to be published by the Department of Health early in the new year.
Kind regards
Simon
Digital Communications Officer
NHS Commissioning Board
I was only aware that the data on performance existed because of an article in The Times today. Even being aware that it must be somewhere on your site, however, did not mean that I could find it at all easily. I went down various blind alleys before by chance coming across the link to it embedded in the text of this page.
That really is not good enough. If it is important, and I think that it is, why is there not a direct link to it under a heading which makes immediate sense to the ordinary reader, rather than ‘Everyone Counts: Planning for Patients 2013/14′? This title implies that it is something to do with future organisation rather than containing a link to a historic data set.
I am afraid that there is very little for the ordinary patient on this site, even if reasonably informed. I don’t think that, as one of the people making up your data, I am likely to have enough information to put any pressure on anyone who could make a difference to my health outcome.
Hi Paul
Thank you for your comments and feedback on the NHS Commissioning Board website, they are much appreciated. To make the area easier to find, I have added a link on the homepage and direct links to the documentation and information packs onto the quick links menu on the right hand side of the screen.
As the NHS CB develops and agrees the processes for citizen voice there will be opportunities for lay member involvement coming up in the future.
Kind regards
Simon
Digital Communications Officer
NHS Commissioning Board
I have another question about the funding formula. At one point, I believe ACRA had the Person-Based Resource Allocation (PBRA) model developed by the Nuffield Trust and its partner research institutions under consideration as the basis for the funding formula for CCGs, and an article was published to this effect in November 2011 (http://www.bmj.com/content/343/bmj.d6608.pdf%2Bhtml). Are the Nuffield PBRA recommendations the basis or a part of the new formula, or will they be considered as part of the review of the allocation model for 2014-2015?
Hi Elliot
Thank you for your comment. The Nuffield Trust Person-Based Resources Allocation is an element of the new formula.
Kind regards
Simon
Digital Communications Officer
NHS Commissioning Board