Bulletin for proposed CCGs: Issue 27, 23 January 2013

23 January, 2013

Contents

Welcome from Barbara Hakin

Dame Barbara HakinWelcome to the latest issue of the bulletin for clinical commissioning groups.

This week the NHS Commissioning Board has authorised and established the second wave of CCGs. Another 67 groups will now able to make commissioning decisions on behalf of their populations, bringing the total across the country to 101, almost halfway to the anticipated total of 211. Authorisation is a tremendous achievement and I’d like to thank everyone involved for your hard work and commitment towards making this happen.

The CCGs authorised this week have demonstrated excellence and a very high level of achievement through the rigorous authorisation assessment, and are clearly ready for the challenge of making a difference to outcomes for their local populations, working with their local health communities, the public and local partner organisations.

I recognise there is some variation in the outcomes. Nineteen CCGs have been authorised with no conditions; 45 have received conditions against some of the criteria, which they should be able to discharge within a short period of time; and three CCGs have been authorised with directions which means that they have legally-binding instructions to take into account when moving forward with their development. I’m confident that with this focused support these CCGs will be able to develop their capabilities over the coming months.

Of course the achievements of the CCGs – and the teams supporting them – in the earlier waves informs the work for those later in the process. And we will continue to work alongside all the CCGs, both up to and beyond authorisation, to ensure we have a clinical commissioning system which delivers real improvements in outcomes and quality for our patients.

Elsewhere in the bulletin this time is further information to help you with the NHS standard contract, advance notice about new audit arrangements and a link to a newly published report, which some of you will have contributed to, on patient and public engagement.

Please do also note the news about the review of urgent and emergency care inEngland. The review will be led by my colleague here at the NHS Commissioning Board, Medical Director Sir Bruce Keogh, but he can’t take it forward without the input and feedback of CCGs. While the review aims to provide a national framework so that high quality, consistent standards are offered across the country, the number and location of services will continue to be developed locally to meet the different needs of urban and rural communities. There will be more information about the review coming out soon as we develop the terms of reference.

As always, if you have any comments, questions or feedback about any aspect of commissioning development, or you would like to be added to the distribution list to receive this bulletin directly, please do get in touch with me via pathfinderlearningnetwork@nhs.net.

Dame Barbara Hakin
National Director: Commissioning Development

Authorisation: Wave 2 CCGs

The NHS Commissioning Board (NHS CB) has authorised the second wave of new clinical commissioning groups to commission healthcare services for their communities from 1 April 2013.

Following a rigorous assessment, 67 more CCGs have been given the go ahead to commission services for their local populations. This brings the total number of authorised CCGs across England to 101, covering a population of over 28 million people.

The NHS CB is responsible for ensuring CCGs meet and maintain standards – as set out in the Health and Social Care Act 2012, the NHS Constitution and the NHS Outcomes Framework.

Nineteen of the 67 CCGs in wave 2 have been authorised with no conditions, meaning they fully met all 119 authorisation criteria. A further 45 CCGs have been authorised with conditions, meaning they will continue to receive formal support to continue their development.

Three CCGs are being authorised on the basis they receive more intensive support from the NHS CB and /or neighbouring CCGs, underpinned by legal directions.

The NHS CB will complete the authorisation process for the remaining 110 CCGs in a further two waves, publishing the outcomes in February and March 2013. At the same time it will continue to work with all CCGs with conditions to help them where possible to fully meet the criteria by April 2013.

Visit the CCG authorisation area to see  more information for wave 2 authorisation including a full summary of the outcomes.

Progress towards CCG set up

As CCGs progress towards ‘go live’ in April 2013, the focus is on the final aspects of setting up CCGs and ensuring the safe transition of commissioning and other responsibilities from PCTs.

CCGs are making excellent progress on the transition from the old system to the new.  AcrossEnglandover 99% of CCGs had completed the NHS staff ring-fenced recruitment process by the end of December 2012 and over 80% of CCG staff have been appointed.

Work is continuing to confirm that CCGs have arrangements in place to support their new organisations, such as payroll arrangements.

As part of the transition of clinical contracts, CCGs are being reminded to make sure they are clear about those contracts for which they are taking on responsibility, and have arrangements in place either directly, or through their commissioning support unit, to manage an effective transition of the contract from the PCT(s) to the CCG.  It is important that this includes engagement with providers as part of the process.

Work will continue with CCGs to track progress and resolve any outstanding issues over the coming months.

Review of urgent and emergency services inEngland

The NHS Commissioning Board is to review the model of urgent and emergency services in England.

The review, led by Medical Director Sir Bruce Keogh, will set out proposals for the best way of organising care to meet the needs of patients. Local commissioning will be at the heart of this review, which follows the Board’s commitment in its recent planning guidance.

The review team will work with CCGs to develop a national framework offer to help them ensure high-quality, consistent standards of care across the country.

It aims to enable CCGs to shape services for the future and put in place arrangements that meet the needs of patients.  The Board will work closely with CCGs to ensure the views of all those with an interest are taken into account.

Emerging principles for the consultation will be published in the Spring. For more information visit the NHS Commissioning Board website.

NHS standard contract: Draft technical guidance

Draft technical guidance for the 2013/14 NHS Standard Contract has been published.

The document is designed to support CCGs in the use of the contract. The contract is for use by commissioners when commissioning healthcare services (other than those commissioned under primary care contracts) and is adaptable for use for a broad range of services and delivery models.

A final version of the technical guidance – which will incorporate any changes required as a result of amendments to the final version of the 2013/14 NHS Standard Contract – will be published shortly, together with the Guide for Clinical Commissioners.

The final version of the 2013/14 NHS Standard Contract will be published on 1 February 2013.

Meanwhile, all CCGs are being encouraged to pre-register to use the secure online commissioning space for generating formal contracts through the NHS Standard Contract.

The ‘e’-contract platform will go live on 1 February and will provide an open access area, with general information, technical guidance and learning tools for all those involved in contracting.

The registration process has been made as quick and easy as possible and takes less than five minutes to complete. Once the request has been validated the NHS Contract team will send a confirmation email.  User names and passwords will be sent out at the end of January ready for the ‘e’-contract launch in February.

For further clarification or support please contact nhscb.contractshelp@nhs.net.

Model agreement for collaborative commissioning

Last year the NHS Commissioning Board published a framework for collaborative commissioning between CCGs which brings together the information and steps CCGs might want to consider in setting up robust collaborative arrangements between themselves.

Following that we shared a draft model agreement for collaborative commissioning between CCGs, asking for feedback. We would like to thank you for your comments on the draft, which were positive and enabled us to provide clarification on a number of points.  The final document has now been published. It is editable for your use as the basis for collaborative agreements and contains a number of guidance notes to help you through the process.

Comments from CCGs also highlighted several common queries about collaborative working, which we are addressing by creating a short FAQs document to accompany the model agreement and this will be published shortly. An updated data table has also been published which shows the relationship between each CCG and its providers based on acute, maternity and ambulance data.

All the documents and information about collaborative working can be found on the CCG resources page.

New arrangements for commissioning support services in South Yorkshire

Ming Tang has been appointed as Director for Data and Information Management Systems at the NHS Commissioning Board and will be leaving her role as Managing Director of South Yorkshire and Bassetlaw Commissioning Support Unit (CSU) later this month.

Alison Hughes, Managing Director of West Yorkshire CSU, will now also take responsibility for South Yorkshire and Bassetlaw CSU.

The changes have been designed to ensure maximum stability and support for CCGs as they continue to prepare for and progress through authorisation.

They will also enable commissioning support services in both areas to continue to develop and improve their service offers and maximise new opportunities for the benefit of customers.

Re-statement of property costs

As part of the work to establish resource baselines for CCGs and the NHS Commissioning Board, an estimate was made of the operating costs of properties used or planned to be used by commissioners that are due to transfer to NHS Property Services or Community Health Partnerships in April 2013.

Since the original cost estimates were collected in July 2012, the position on property transfers has changed and the value of recharges to current building users has become clearer.

Therefore, updated property costs are now being collected from PCTs which will be used to confirm the initial recharges that will be made in 2013/14 for the use of properties by CCGs and the NHS Commissioning Board.

CCG Chief Financial Officers will be involved in signing off the updated cost estimates. Where there are significant revisions to the original cost estimates, it may be necessary to action changes to baseline allocations in 2013/14.

For further information, please contact Robert Maden at robert.maden@nhs.net

Audit arrangements for CCGs

Under the Health and Social Care Act 2012 the NHS Commissioning Board is responsible for making arrangements for appointing auditors to CCGs.

The Board has now asked the Audit Commission to undertake this on its behalf – requesting that the Commission appoint auditors to audit the accounts of all CCGs, with effect from 1 April 2013in accordance with the Audit Commission Act 1998.

The Audit Commission will now be writing to all CCG Accountable Officers setting out a consultation process naming the proposed auditors for each CCG. The purpose of the consultation is to primarily check for independence and that no conflicts of interest exist. This is so that 2013/14 appointments may be made soon after the CCGs are established.

For more information please contact sheenagh.powell@nhs.net.

Embedding patient and public participation

A number of wave 2 and 3 CCG leaders have taken part in a research exercise looking at embedding patient and public participation in commissioning.

The CCG leaders – lay members, clinical leads and accountable officers – were asked about their development and support needs in the areas of patient and public participation.

The research provides a rich picture of CCG needs, valuable evidence about the impact of existing support and insight about preferences for future support. It suggests that CCGs understand the future importance of good engagement in their commissioning but many are in need of practical help to turn that intent into sustainable and meaningful engagement with patients and the public.

The report, commissioned by the Department of Health, has now been published and both a summary and the full report are available to download here.

The future role of pharmacy: Event invitations

A series of events is being held around the country to raise awareness of the important role that pharmacy can play – and is playing – in delivering effective public health services in England. CCGs will want to be aware of the important contribution that pharmacy can make to improve health locally.

Community pharmacies are increasingly delivering a wide range of public health services from stopping smoking to sexual health, weight management, alcohol interventions, needle and syringe exchange schemes, supervised administration of methadone and flu immunisations.

These events are open to pharmacists and their teams, CCGs, Health and Wellbeing Boards, Local Authorities, the voluntary sector and public health professionals. The events are intended to be both informative and interactive, stimulating discussion and feedback.

If you would like more information or to book a place, details of the events are shown below.

  • 25 February, 12.30pm – 4pm, University of Staffordshire. Contact Carla Glanville on 0207 972 3113 or carla.glanville@dh.gsi.gov.uk
  • 26 February, 9.30am – 1pm, The Yorkshire Museum, York. Contact Rachel Oxtoby on 01904 551984 or rachel.oxtoby@york.gov.uk
  • 27 February, 12pm – 4pm The Royal Society for Public Health, London. Contact Pauline Johnson on pjohnson@rsph.org.uk
  • 20 March, 12.30pm – 4pm, Buckfast Abbey, Buckfast. Contact Pauline Johnson on pjohnson@rsph.org.uk

New IT specifications to support care co-ordination

A major challenge in providing care for patients with complex long term conditions and those approaching end of life is sharing key care planning information and patient preferences between the various services providing care and support for the patient.

Commissioning joined-up service provision to cope with these patients will be a key challenge for CCGs into the future, as most current clinical systems do not provide the shared information required to support this new integrated way of working.

Teams at NHS Connecting for Health have been working with a group of trusts and suppliers to define a new set of technical specifications to better support the co-ordination of care.

These specifications will support suppliers in exchanging important information between IT systems so that clinicians can easily see when important events have occurred, such as updates to a patient’s care plan. It will then allow them to access the updated information within their own clinical systems. This will support integrated team working, by ensuring all relevant information is brought together, without the need for manual re-keying into multiple IT systems.

For more details, visit the Interoperability Toolkit site on NHS Networks. The team is interested in hearing from anyone who has comments or feedback on the specifications, and is also looking for teams who are interested in implementing the specifications or using them as the basis for commissioning new services. Please contact qippdt@nhs.net.

Supporting research in primary care: Correction

In issue 25 of the CCG bulletin (18 Dec 2012) the item Determining arrangements for supporting research in primary and community care opened with the sentence, “From April 2013, CCGs will have a legal duty to promote research and the use of evidence to support commissioning.”

In fact, CCGs will have this duty from the date of their authorisation. We apologise for the inconvenience and please note the correction.

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