Providing online support, resources and information for clinical commissioning groups (CCGs).
- Clinical streaming principles
- Transfer of Commissioning Responsibility to CCGs for Adult Obesity services 2016/17 Guidance for CCGs
- Specialist Level Palliative Care: Information for Commissioners
- Commissioning person centred end of life care – a toolkit for health and social care
- Framework for Commissioning Community Nursing
- CCG Finance and Activity Planning information 2015/16
- Mental health commissioning resources
- New framework for responding to CQC inspections of GP practices
- Mapping the market – Commissioning support services
- Clinical Commissioning Groups’ accounts
- CCG configuration
- CCG engagement
- CCG organisation development
- CCG finance
- CCG’s responsibilities as data controller
- CCG governance
- CCG outcomes
- Children and young peoples diabetes transition specification
- Commissioning intelligence
- Commissioning support
- Complaints handling
- Good data strategy
- GP IT
- Health and wellbeing boards/Working with your local authority
- Human resources
- Information governance
- Integrated Support and Assurance Process (ISAP)
- Managing conflicts of interest
- National Business Continuity
- NHS Standard Contract
- Palliative care currency
- Patient and public participation
- Planning, assuring and delivering service change for patients
- Serious Incident Framework
- Never Events Policy and Framework
- Primary care commissioning
- Primary medical care functions delegated to CCGs
- Procurement of healthcare (clinical) services: Briefings for CCGs
- Operational pressures escalation levels framework
- Quality premium
- Reducing pharmaceutical waste
This letter and document from Pauline Philip, National Director for Urgent and Emergency Care, details principles for clinical streaming in A&E departments. These principles have been developed in order to support local planning and decision making to achieve the NHS’ commitment of providing a comprehensive front-door clinical streaming service in every hospital by October 2017. These principles and the Royal College of Emergency Medicine guidelines refer to clinical streaming at the front door of ED, including to primary care services, as being an integrated function
- Clinical streaming in the A&E department
- Letter from National Director for Urgent and Emergency Care for the clinical streaming principles
Transfer of Commissioning Responsibility to CCGs for Adult Obesity services 2016/17 Guidance for CCGs
NHS England Specialised Commissioning is supporting the transfer of obesity surgery to Clinical Commissioning Groups from 1st April 2016. It is leading on the contract negotiations for 2016/17 against the current specification and access criteria. NHS England with the Obesity Surgery Clinical Reference Group has prepared guidance for CCGs, for commissioning this year and from 2017/18
- Appendix 4 CCG Pack A05-S- 1617 Current Complex Obesity Service Specification
- Appendix 5 a05- CCG Pack Current service spec-comp-obesity 2013
- Appendix 6 CCG Pack A05- 201617 policy-a sev-comp-obesity pdf
- Appendix 7 Obesity Surgery CCG Guidance
- Appendix 8 Revision Surgery CCG Guidance
- Appendix 9 Service Spec CCG Guidance
The NHS has responded with energy and enthusiasm since the publication of the Five Year Forward View (2014), with local and national bodies coming together to lay the foundations for its vision for 2020 and start delivering it. For End of Life Care, September 2015 saw the publication of the “Ambitions for Palliative and End of Life Care: A National Framework for Local Action 2015-2020”, published by 27 national partners, including NHS England.
To support the work being undertaken to realise the Ambitions, NHS England has published Specialist Level Palliative Care: Information for commissioners’. The aim of this publication is to help commissioners understand the characteristics and benefits of Specialist Level Palliative Care (SLPC) for adults, and to explain how SLPC fits within the different components of end of life care (EoLC) provision in any care setting.
The guidance encourages commissioners to take a collaborative approach to system leadership, as advocated by the Five Year Forward View (FYFV). It acknowledges that single providers alone will not always be able to meet all the specified criteria, and supports commissioners to take a whole-system, whole population view.
It is intended to assist commissioning discussions, at a local system level alongside the newly refreshed toolkit “Commissioning person centred end of life care”, to inform discussions between commissioners and local SLPC providers. The toolkit provides a valuable supporting resource for the commissioning process and an interactive directory of current guidance.
For more detailed information please Sarah Mitchell’s blog – Realising ambitions: improving palliative and end of life care for all in three steps.
Providing high quality end of life care that is truly centred around the needs of the individual and their loved ones is an important outcome to aim for. Given the complexity of ensuring all the patient’s needs are met, wherever possible, requires all the agencies to work together.
The ‘Ambitions for Palliative and End of Life Care: A national framework for local action 2015-2020’, stresses how we must all work together to find new ways of delivering better care to make a difference. The role of commissioners in collaborative working continues to be fundamental in making progress in end of life care.
NHS England’s Sustainable Improvement Team has refreshed the toolkit “Commissioning person centred end of life care”. The guide identifies the main elements involved in commissioning end of life care services, explains the commissioning cycle in practical terms and offers a staged approach. It also provides a wide range of links to tools and sources of support for both commissioners and providers of services. It also showcases good practice and seeks to indicate what a well-commissioned end of life care service looks like.
The toolkit is aimed at being a useful resource which is complimentary to the overall national strategic direction, whilst aiming to support commissioners ‘commission high quality end of life care’ and to be complimentary to their local Sustainable Transformation Plans.
The Sustainable Improvement Team, NHS England, was commissioned by Professor Bee Wee, National Clinical Director for End of Life Care, NHS England, to work with a range of partners to produce the commissioning toolkit. They are: CCGs, Help the Hospices, Marie Curie Cancer Care, Macmillan Cancer Support, the National Council for Palliative Care, NHS South of England, NICE, SCIE, ADASS and the Royal College of General Practitioners.
The framework for commissioning community nursing is in response to the Five Year Forward View. It focuses on community nursing whilst recognising that greater integration for health and social care will be needed to meet future needs
The CCG Finance and Activity Planning information is an extract of the data from CCG plans submitted in May/June 2015. The data includes:
- CCG commissioned activity broken down into outpatient, day case, elective, non-elective and A&E attendances for 2014/15 outturn and 2015/16 plans.
- CCG programme costs broken down by acute, community, continuing care, mental health, other programme and primary care for 2014/15 outturn and 2015/16 plans.
- CCG QIPP information for 2014/15 outturn and 2015/16 plans including the financial value and the percentage of total allocation the QIPP plans represent.
Please note that accurate comparisons using this data, between years and across CCGs, is not possible due to the impact of factors such as non-recurrent adjustments and the Better Care Fund, as well as local factors specific to each CCG.
The CCGC files contain a Clinical Commissioning Groups’ accounts data, together with other information to aid our consolidation of the accounts, and additional information required by the Department of Health. Where a Clinical Commissioning Group prepares consolidated accounts the CCGC contains only the group figures from the Clinical Commissioning Groups’ consolidated accounts. The data set published here is limited to the CCGC information that Clinical Commissioning Groups are required to include in their annual accounts. The information contained in this file is already available in individual Clinical Commissioning Groups’ annual reports as laid before Parliament and published on the Clinical Commissioning Groups’ website. The intention of this data file is to make this data easier to locate and manipulate.
This file does not contain consolidation adjustments we make in preparing the consolidated accounts. Upon consolidation NHS England makes adjustments including eliminating income and expenditure between CCG’s. For this reason the totals of the data included in this file will not agree to the NHS England Consolidated Group Accounts.
Two files have been published, which should be used together:
- All of the CCGC data published in the accounts of the 209 Clinical Commissioning Groups as at 31 March 2017; and
- Illustrative CCGC file to assist the user in understanding the data being presented
- How to use the 2016-17 data file
2016 data files
- All of the CCGC data published in the accounts of the 209 Clinical Commissioning Groups as at 31 March 2016; and (8MB)
- Illustrative CCGC file to assist the user in understanding the data being presented
- How to use the 2015-16 data file
2015 data files
- All CCGC data published in Clinical Commissioning Groups’ accounts 2014/15 (8MB)
- Illustrative CCGC file to help you understand the data (7MB)
- How to use the 2014-15 CCGC data set
CQC have begun to inspect and rate every GP practice in England. Practices will be rated in one of four categories; ‘outstanding’; ‘good’; ‘requires improvement’; or ‘inadequate’. A new guidance framework has been developed to ensure that there is a consistent approach for CCGs, area teams and CQC to work together before, during and after inspections and for responding to instances where practices are rated inadequate.
In such instances, teams and CCGs should be working with practices to ensure there are clear and transparent improvement plans in place and consider appropriate interventions if services to patients are at risk. This framework describes how teams and CCGs should:
- collaborate with CQC to ensure ongoing monitoring and surveillance of contracts, prior to and during practice inspections to share intelligence.
- support practices rated inadequate in one of the key domains or population groups by putting in place an improvement plan and signpost to external support to ensure sustained measurable improvement.
- oversee progress against improvement plans and take further contractual action if there is no demonstrable improvement.
Mapping the market charts some of the CSU and Independent sector commissioning support market; including some of the significant changes which are already taking place as the market for CSS evolves. There is a tangible sense of momentum and improvement. It is a useful read to understand some of the products and services available to commissioners and CCGs.
- Diagnostic tool for emerging CCGs and supporting info for diagnostic tool
- Framework for collaborative commissioning between CCGs
- Model Collaborative Commissioning Agreement (single contract option)
- Model Collaborative Commissioning Agreement (multiple contract option)
A range of Organisation Development (OD) resources are now available (below) to CCGs. This work has been led by members of an OD project group that was established last autumn under the work programme of the Commissioning Assembly CCG development working group.
Connect and share experiences: A specific CCG OD network is available as part of the wider NHS Employers “DoOD” network. To join please contact; firstname.lastname@example.org or visit the LinkedIn group ‘CCG Organisational Development Network’.
Financial sanctions 2015/16
NHSI and NHSE have agreed to vary the financial sanctions framework for 2015/16.
Commissioners should continue to levy fines as for the first half of the year. However, with effect from 1 January 2016 either the commissioner returns fines to providers to support provider financial positions (and so should not result in additional expenditure), or retains the money to create an underspend, improving the bottom line.
Allocation of resources 2016/17 – 2020/21
The Technical Guide to Allocation Formulae and Pace of Change for 2016-17 to 2020-21 revenue allocations to Clinical Commissioning Groups and commissioning areas is also available together with supporting documents, research reports and spreadsheets.
- Financial allocations 2016/17 – 2020/21
- Total place allocations
- CCG allocations
- Primary Care medical allocations
- Running cost allowances
- Specialised Allocations
- CCG Summary Statements
- Allocations – Frequently Asked Questions
Allocation adjustments for 2017/18 and 2018/19
Allocation of resources 2015/16
- Allocations publication letter
- Annex A Guidance Summary of Allocations
- Annex A Summary Allocations
- Annex B Guidance CCG Allocations Guidance Notes
- Annex B CCG Allocations
- Annex C Guidance Primary Care Guidance Note
- Annex C Primary Care Allocations By Team
- Annex D Guidance Specialised Services Mapped to CCG Level
- Annex D Specialised Services
- Who pays? Determining responsibility for payments to providers
- Improving Systems for Cost Recovery for Overseas Visitors: Interim guidance, May 2015
NHS England and the Health and Social Care Information Centre have written a letter outlining commissioners’ responsibilities as data controllers, with respect to the data that is processed on their behalf by Data Services for Commissioners Regional Offices. The letter also confirms the actions that CCGs need to take to ensure that they can continue to receive patient level data where required to support commissioning activities. Further guidance is also provided. Queries can be directed to email@example.com.
- Procedures for CCGs to apply for constitution change merger or dissolution – November 2016
- Appendix A – The functions of CCGs
- Appendix C – Appointment to CCGs of pharmaceutical services remuneration
- Best practice resource/practical toolkit – for the appointment of lay members to clinical commissioning groups
- Delegation of commissioning and legal status of emerging clinical commissioning groups
- Interim governance arrangements for pathfinder CCGs
The following resources have been provided to help emerging clinical commissioning groups as they work towards becoming established. They should be read in conjunction with Towards establishment: Creating responsive and accountable clinical commissioning groups published in February 2012.
The resources, which are optional, are designed to be flexible and to be tailored for local use. CCGs may choose to use all or certain aspects of each resource or create their own.
NHS England has published revised CCG guidance on senior appointments, including accountable officers, and a new appointment pro forma. The guidance was originally published in January 2014, and was refreshed in October 2015 to take into account changes within the structure of NHS England. This guidance has been refreshed again, with minor updates to the following areas:
- An update to the new appointment pro forma, which requests additional information on candidates, their experience, and further scrutiny around interim appointments in line with payroll and agency spend guidance;
- Updated guidelines around remuneration; and,
- Updated guidance on eligibility for the role of accountable officer
- Clinical commissioning group guidance on senior appointments, including accountable officers (gateway ref 06483)
- Insight roundtable: Commissioning for outcomes, with links to case studies
- The CCG Outcomes Indicator Set 2013/14 and 2014/15
- CCG Outcomes Tools
- Example service level agreement from Greater East Midlands CSU
- Example service specification: clinical procurement from Greater East Midlands CSU
- Example service specification: communications and engagement from Greater East Midlands CSU
- Advice on whether to Make, Share, or Buy
- Make Share Buy Advice supporting letter: a supporting letter to CCGs from NHS Clinical Commissioners, the Commissioning Assembly Commissioning Support working group and NHS England.
NHS England recognises that high quality commissioning requires expert commissioning support which can come from a range of providers including voluntary sector organisations. A new report ‘Role of the voluntary sector in providing commissioning support’ by the Nuffield Trust in conjunction with Macmillan, ACEVO, Neurological Commissioning Support and NHS England, looks at the potential expertise they can bring to this area. The report sets out key recommendations and action points for VSOs, CCGs, CSUs and NHS England, which we hope will enable all commissioners to access excellent and affordable commissioning support.
The NHS 111 National Business Continuity Escalation Policy sets out the policy and process for the deployment of national business continuity. It outlines how and when the service should be activated and how this is governed.
Two new toolkits have been launched today (30 Nov 2015) by NHS England to support commissioners in the assurance of good complaints handling.
- Assurance of Good Complaints Handling for Primary Care – A toolkit for commissioners
- Assurance of Good Complaints Handling for Acute and Community Care – A toolkit for commissioners
The toolkits have been co-designed and tested with a group of stakeholders including CQC, PHSO, Monitor; CCG’s, Complaints Managers Forum and complaints advocacy support. A number of CCGs have tested the toolkits for ease and usability. This design process has identified that there is a requirement to develop two Toolkits, one for commissioning of primary care and one for the commissioning of acute, community and mental health care.
The aims of the Toolkit are to ensure:
- All complaints are well managed
- The learning from complaints is identified and used for improvement
- The complaints service is accessible, open and transparent.
- CQUIN 2016/17
- CQUIN 2015/16
- CQUIN 2014/15
- CQUIN 2013/14
- NHS Standard Contract
- Additional guidance on the national mental health indicator
- Letter to CCG’s regarding National CQUIN for Venous Thromboembolism
In 2014 we published our vision for a high quality data set.
- JSNAs and joint health and wellbeing strategies explained
- Local Healthwatch – the policy explained
- Building successful HWBs – slide packs and video resources
This document describes the integrated NHS England and NHS Improvement process for supporting commissioners and providers looking to procure and bid for complex contracts. It replaces the introductory document published in November 2016.
This guidance has three parts:
- Part A: Introduction to the ISAP for commissioners and providers looking to procure, or bid for, a complex contract;
- Part B: The questions that will be asked and the submissions from commissioners expected at each stage of the ISAP; and
- Part C: Guidance for NHS trusts and foundation trusts looking to bid for a complex contract. This may also help independent providers bidding for such contracts.
The Health and Social Care Act sets out clear requirements of clinical commissioning groups (CCGs) to make arrangements for managing conflicts of interest and potential conflicts of interest, to ensure they do not affect or appear to affect the integrity of the CCG’s decision making processes.
The Managing Conflicts of Interest guidance, replaces previous guidance published in June 2016. It strengthens the previous guidance in recognition that primary care co-commissioning is likely to increase the range and frequency of real and perceived conflicts of interest, especially for delegated arrangements. The guidance has been developed in partnership with NHS Clinical Commissioners.
NHS England has worked with providers and commissioners to undertake qualitative and quantitative testing of the Specialist Palliative Care Currencies for Adults and Children. We have published a report on the outcomes of this testing and are making the currencies available to use from April 2017. We have also produced two guidance documents to help organisations who wish to use the currencies to support commissioning of these services.
You can find a range of resources to support your patient and public participation work on the Involvement Hub.
- Shared Planning Guidance
- Resilience planning for early 2015/16 – NHS England along with national tripartite partners (NHS TDA, Monitor, and ADASS) set out planning requirements for the Easter bank holiday period, and April 2015 in general. This letter sets out expectations for planning for the bank holiday period when demand is expected to increase, continuation of resilience schemes in 2015/16, and the ‘National Breaking the Cycle’ initiative for the first two weeks of April.
- Planning for operational resilience in health and social care during 2014/15 – funding to support ambulance services (this document is no longer available here but can be found on the National Archives website)
This guidance is designed to be used by those considering, and involved in, service reconfiguration to navigate a clear path from inception to implementation. It will support commissioners to consider how to take forward their proposals, including effective public involvement, enabling them to reach robust decisions on change in the best interests of their patients.
In addition, it sets out how new proposals for service change or reconfiguration are tested through independent review and assurance by NHS England.
This document replaces ‘Planning and delivering service change’, published by NHS England in December 2013. Clinical Commissioning Groups (CCGs) are under a statutory duty to have regard to this guidance.
- Enhanced services commissioning factsheet – available on our archived website
- Securing excellence in commissioning primary care
NHS England has the power to direct a CCG to exercise any of its functions relating to the provision of primary medical care services. This guidance sets out the arrangements for CCGs to commission out-of-hours primary medical services for their area.
Working with CCGs and others, NHS England has developed procurement briefings for CCGs that summarise the key elements of legislation and guidance governing NHS procurement of healthcare services. These briefings also provide an overview of the different approaches that CCGs may adopt and outlines some of the key considerations when undertaking procurement.
The briefing papers cover:
- How does procurement fit with the different stages of commissioning?
- How should a procurement process be conducted?
- Introduction: Why do CCGs need to understand procurement?
- Summary of the decision-making process.
- What are the procurement options?
- Which rules apply to a procurement process?
The GP IT Operating Model 2014
NHS England published the GP IT Operating Model in March/April 2014, building on and updating Securing Excellence in GP IT first published in December 2012. The model and supporting materials describe the operating and financial arrangements for the delivery of world-class IT in GP practice. CCGs will be at the forefront of managing the funding, ensuring there is flexibility at practice and local level set around a core national IT offer. Find out more on the ‘Information technology in primary care’ page.
Children and young peoples diabetes transition specification – This diabetes transition service specification document sets out a best practice model and considerations to be made by commissioners in stipulating and providing services for young people with diabetes through transition and as young adults.