Specialised health services commissioned by NHS England.
Specialised services commissioning documents
- The Operating Model for Specialised Services Commissioning
The new operating model for commissioning specialised services sets out how a single, national system ensures patients are offered consistent, high-quality services across the country.
- The Commissioning Intentions for 2013/14
Commissioning intentions have been published annually by the NHS and detail the basis of contracting for the coming year. This year, for the first time, there is a single set of nationally consistent intentions for a discrete range of clinical services. They underpin the new system set out in the operating model and, together, these documents ensure that delivery, quality and access for all prescribed specialised services is standard across the country.
- Frequently asked questions
- Key messages for the NHS CB Regions and the Local Area Teams
Since April 2013, NHS England has had responsibility for directly commissioning all prescribed specialised services. ‘Prescribed’ specialised services are those ‘tested’ against the four factors in the Health and Social Care Act 2012 as suitable for commissioning by NHS England. The four factors are:
- The number of individuals who require the provision of the service or facility;
- The cost of providing the service or facility;
- The number of people able to provide the service or facility; and
- The financial implications for Clinical Commissioning Groups (CCGs) if they were required to arrange for the provision of the service or facility
- The Manual
The manual is a technical document describing the 143 prescribed specialised services. Some elements of these are to be directly commissioned by NHS England and some are to be commissioned by CCGs. It gives details of each service to be commissioned and a rationale as to why a service is to be commissioned by NHS England and not by CCGs.
- Identification Rules
The identification rules (IRs) are the means by which specialised activity will be identified and captured by providers of prescribed specialised services. The IRs enable providers to separate specialist activity from standard inpatient and outpatient activity, and therefore which services are being commissioned by NHS England and which by the CCGs.
- Identification Rules for Trust Information Managers
The introduction of the identification rules for prescribed specialised services activity will, for some provider organisations, require operational changes to enable the accurate collection and identification of data. This document has been written to provide tailored support and guidance to trust information managers, in particular to share some of the knowledge gathered in the testing phase of the IRs and hopefully minimise any potential disruption that this reporting change may impose.
We would welcome any feedback, via our online survey, which providers and commissioners in particular may have about the manual and/or the identification rules. We will collate all feedback and use it to inform future iterations of these documents.
Clinical Advisory Group for Prescribed Services
- Next steps on the Clinical Advisory Group’s recommendations for specialised services
- Frequently asked questions
Registration for chairs and clinical membership of the 2013 Clinical Reference Groups
The NHS England Medical Directorate has opened registration for membership of the 2013 Clinical Reference Groups (CRGs) which support directly commissioned specialised services. A guide to CRGs, aimed primarily at clinical staff, provides background information about the CRGs, and an introduction to the work programme for the groups for the coming year. Recruitment is now open for chairs and clinical members. There will be further recruitment of non-clinical members.
- Clinical Reference Groups for specialised services: A guide for clinicians
- Clinical Reference Groups membership page
Consultation on service specifications and clinical policies
All patients requiring treatment from a specialised service are to have access to the same standard of service and the same clinical policy wherever they live. The nature and extent of this specialised care was subject to a consultation by the NHS Commissioning Board, now NHS England. This consultation is now closed.
Clinical commissioning policies for specialised commissioning
New, nationally consistent clinical commissioning policies for specialised services have been published. These policies have been informed and shaped by the views of patients, carers, the general public and wider stakeholders collated during a short consultation which ran from December 2012 to February 2013.
See the final versions of the policies, which have been adopted by NHS England.
National Programmes of Care and Clinical Reference Groups
NHS England is working with a range of stakeholders at a national level to determine the outcomes expected for specialised services. This will be achieved through the development of clinical strategies set out within five national Programmes of Care (PoC) which group together the prescribed (nationally agreed range of) specialised services. These strategies will enable the commissioning of services to be based on clear evidence and ensure that they are cost effective and patient focussed. The five national PoCs are:
- Internal Medicine - digestion, renal, hepatobiliary and circulatory system
- Cancer and Blood - infection, cancer, immunity and haematology
- Mental Health
- Trauma - traumatic injury, orthopaedics, head and neck and rehabilitation
- Women and Children - women and children, congenital and inherited diseases
Specialised services Clinical Reference Groups (CRGs) have been established to cover the full range of specialised services within these national PoCs.
CRGs bring together representatives including clinicians, commissioners, Public Health experts and the patients and carers who use the relevant specialised services. Together the members form a group which can advise with authority and expertise about a particular area of specialised healthcare. Members are volunteers who have a particular interest, knowledge or experience of a specific area of specialised healthcare and wish to contribute to its development.