NHS Commissioning Board consults on specialised services

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 are subject to a consultation, launched today by the NHS Commissioning Board.

The six week consultation running from 12 December 2012 to 25 January 2013 will seek the views of patients and carers, patient groups, charities, nurses, doctors and service providers on 120 draft service specifications and 43 underpinning clinical commissioning policies.

Developed by expert clinicians, commissioners of care and patient representatives working closely together, this nationally consistent approach aims to provide patients across England with high quality care and equitable treatment.

The detailed service specifications embrace a wide variety of complex conditions ranging from cleft lip and palate surgery, cystic fibrosis, sickle cell and thalessaemia to neurology, secure mental health services and children’s cancer services. The consultation will provide feedback on whether the specifications and accompanying policies are clear, comprehensive and take into account everyone who may be affected by them.

The specifications directly spell out what commissioners will want from a service in terms of clinical practice, evidence base, quality standards and access criteria. There are significant variations in access to specialised care across England and a consistent approach to planning and commissioning, delivered at a local level, will help to tackle these differences and ensure everyone receives the same standard of care.

The service specifications describe core and developmental standards, clearly defining what the NHS CB expects to be in place for providers to offer evidence-based, safe and effective services. Core standards are those that any reasonable provider of safe and effective services should be able to demonstrate. Developmental standards are those that are designed to stretch services over time to provide excellence in the field.

One example of improvement in patient care achieved through this national approach will be the establishment of a single commissioning policy providing the same access to surgery for individuals who are morbidly obese. Currently there are five differing levels of access to surgery across the country for patients with morbid obesity.

Obesity is one of the leading preventable causes of death and the NHS Commissioning Board’s intention to nationally commission against NICE guidelines for this condition will help to reduce incidences of type 2 diabetes and hypertension.

The recently published Operating Model for commissioning specialised services set out how the move from ten differing regional processes to a single national approach based on best clinical evidence and systematic patient feedback will improve services for patients.

Where providers are unable to move to the agreed common standards by April 2013, the NHS Commissioning Board will put in place time limited exceptions (or derogations) allowing providers to continue providing essential quality services for their patients whilst working to meet the new rigorous and coherent service specifications.

The high degree of transparency in this process, will guarantee patients and their families know what to expect from their locally available services. At the same time should patients live in more isolated or rural areas, they will be aware what developments are required to bring these services up to the agreed national specification.

James Palmer, Clinical Director for Specialised Services at the NHS CB said,

“At the heart of this new approach is our commitment to ensuring patient safety and providing consistent standards of care and accessibility to all who need these services regardless of what part of the country they live in. We want to set the bar high and have a nationally consistent system of care that is fair to all.

“At the same time we want to build high quality long term relationships with specialist providers to improve the services we offer and work with commercial organisations to keep pace with new drugs and technologies that come on stream.

“We want to hear from providers, medical staff, patients and groups supporting these specialist areas as to how we can make these services work better for patients and their families.  If change is necessary we will address this.”

To make the consultation process as smooth as possible the NHS CB has developed an online platform where all the materials can be viewed and responses posted. A final report outlining the new arrangements for specialised clinical commissioning is expected to publish in February 2013.

You can find more information on the consultation on our specialised services commissioning pages.