Clinical Priorities Advisory Group (CPAG)

The Clinical Priorities Advisory Group (CPAG) makes recommendations on NHS England’s approach to commissioning services, treatments and technologies, and considers which of these should be prioritised for investment. Its scope includes all specialised services of NHS England.

CPAG assesses medicines, medical devices and treatments according to their clinical effectiveness, benefit for patients and value for money. It considers recommendations from integrated care boards (ICBs) and teams covering NHS England’s specialised commissioning responsibilities, and takes into account detailed information about the financial impact.

It seeks to determine that commissioning approaches have:

  • been developed with the engagement of clinicians from clinical reference groups or bespoke policy working groups
  • been developed with public and patient engagement to a level proportionate with the impact of the decision
  • included consideration of the need to promote equity of access and tackle health inequalities
  • been informed by the clinical evidence base
  • considered consistency with other commissioning policies of NHS England.

CPAG is not a decision-making body, rather it makes formal recommendations to NHS England about the commissioning of services in those circumstances where there could be a substantial change in service provision.

Making decisions about which new treatments to fund:


CPAG is able to call on the full range of expertise of its members to make recommendations: its independent chair, patient and public voice representatives and members with clinical, commissioning and financial expertise. As and when appropriate, CPAG engages with other NHS commissioners and stakeholders and calls on sources of sound evidence from outside the NHS, professional bodies, and other relevant organisations.

Voting members:

In attendance:

  • James Palmer, Medical Director of Specialised Commissioning, NHS England (Ex Officio)
  • Donna Hakes, Head of Clinical Effectiveness, Specialised Services, NHS England (Ex Officio)
  • Katie Cusick, Head of Acute Programmes, Specialised Commissioning, NHS England
  • Anthony Kessel, Clinical Director, Clinical Policy Team, Specialised Commissioning, NHS England
  • Ayesha Ali, Medical Advisor to Highly Specialised Commissioning, NHS England
  • Agnieszka Rawlings, Business Manager, Clinical Effectiveness, Specialised Services, NHS England
  • Emily Aidoo, Project Manager, Clinical Effectiveness, Specialised Services, NHS England
  • The Specialised Commissioning Programme of Care Senior Manager relevant to the policy proposition or other proposals being considered.

Observers – representatives from the devolved nations:

  • Iolo Doull, Wales
  • Craig Wheelans, Scotland
  • Anna Lamont, Scotland
  • Hester Ward, Consultant in Public Health Medicine, Public Health Lead, National Planning, National Services Division, NHS Scotland.

Terms of reference