Delegating commissioning functions to ICBs offers real opportunity to improve local health outcomes

On the 1 April, integrated care boards (ICBs) will take on delegated responsibility for commissioning pharmacy, general ophthalmic, and dental (POD) services from NHS England.

This is a significant milestone and supports our long-term and continuing ambition to put decision-making at as local a level as possible to meet the ‘triple aim’ of better health for everyone, better care for all patients, and efficient use of NHS resources, both for local systems and for the wider NHS.

The delegation of direct commissioning functions is a key enabler to realising this ambition. By giving ICBs responsibility for a broader range of functions, they will be better able to design services around the needs of their local communities.  That is what integrated care is all about; joining up care and targeting our resources where they are needed most.

​Nine ICBs have already taken on responsibility for one or more POD functions.

In Greater Manchester ICB, local commissioning of POD services is already making a difference. Oral health is being transformed by a joined-up approach with partners across health and care, who are addressing the challenges holistically around oral health not just as a dental services issue.

POD services are also now part of system wide considerations when issues such as winter planning are being discussed. The Greater Manchester primary care board, a strong provider collaborative for primary care colleagues, has established quality initiatives across POD and primary medical care, as well as considering the services from population health and primary care perspectives.

In Cheshire and Merseyside, the ICB has put in place ‘deep dive’ meetings for dental contracting where different stakeholders are brought together to discuss risks, challenges and the strategic direction of the service. This engagement is broad, involving local HealthWatch and MPs, as well as local service providers and others directly or indirectly involved in the provision and commissioning of care, such as public health colleagues.

Supporting the safe delivery of these functions will also see some of our staff transferring from NHS England to ICBs by July. Their expertise and knowledge will be vital in the smooth transfer of these services to systems and to help design effective operating models in the context of a wider range of responsibilities. We also recognise that systems will take control of commissioning functions as services remain under pressure in many parts of the NHS, and it is our commitment to continue to work hand in hand with ICBs to ensure this change can deliver on its promise for patients and for our network of providers. I want to thank all staff for their hard work and dedication during this transition.

​We are committed to creating the conditions that will allow ICSs to succeed and as we look to the future, we will further empower ICBs by delegating more of our commissioning responsibilities, giving local leaders the tools they need to improve the health and wellbeing of people in every community across the country.

Ali Sparke

Ali Sparke, Director for Pharmacy, Optometry, Dentistry and the NHS Standard Contract, NHS England

Ali has worked with the NHS for over 10 years. He has been the director responsible for Dental services, alongside Community Pharmacy and Optometry since August 2021. Prior to he led the wider primary care team’s incident response to Covid-19 and his work in NHS England has included wider contracting reform supporting integrated care, and leading development of quality improvement incentives for community, mental health and secondary care services through the CQUIN scheme.