NHS England has finite resources, and needs to make decisions to ensure the best possible outcome for all of the patients for whom it has commissioning responsibility.
Decisions must be made in a systematic, consistent and transparent way, with the aim of fairly and rationally distributing these resources across different patient groups, and across competing demands.
NHS England is currently using the interim Ethical Framework to underpin its decision-making.
The interim Ethical Framework sets out 15 ethical principles, some of which relate to legal and statutory duties, and have to be adhered to by NHS England as a public body.
These principles, along with the generic commissioning policies, and some standard operating procedures, need to be applied consistently, throughout a structured governance process. Without these elements, a public organisation cannot deliver fair and robust decision-making.
NHS England is currently reviewing its interim Ethical Framework and policies, in partnership with its stakeholders, as part of the development of a comprehensive Prioritisation Framework to support future decision-making. View more information about Revising the Ethical Framework and Commissioning Policies.
- Ethical Framework for Priority Setting and Resource Allocation: Sets out a framework for fair and consistent decision-making for the direct commissioning arm of NHS England
- Commissioning Medicines for Children in Specialised Services
- Experimental and Unproven Treatments: Sets out the circumstances in which NHS England may wish to fund a treatment or intervention which is either considered experimental or not to be of proven effectiveness
- Clinical Service Derogation of Commissioned Specialised Services: Sets out the circumstances under which clinical providers may apply for a derogation, or temporary delay, in meeting key service requirements in full, as described in the service specification, or other mandatory commission requirements
- Commercial Service Derogation of Commissioned Specialised Services: Sets out the circumstances under which commercial providers may apply for a derogation, or temporary delay, in meeting key service requirements in full, as described in the service specification, or other mandatory commission requirements