Asked by: Karin Smyth (Labour - Bristol South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to ensure that integrated care boards take into account a) clinical, b) patient and c) provider experience when commissioning specialised services.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
NHS England's delegation agreement with the integrated care boards (ICBs) requires each ICB to establish effective, safe, efficient, and economic arrangements for the commissioning of delegated specialised services, with particular reference to statutory obligations relating to health and care bodies, such as the triple aim.
The delegation agreement supports these responsibilities, including following all relevant legislation, guidance, and good practice. In commissioning delegation specialised services, ICBs must: consider how they can meet their legal duties to involve patients and the public in shaping the provision of services; work with local communities, under-represented groups, and those with protected characteristics; consider how they can address health inequalities; assist in the development of national standards, including service specifications and clinical commissioning policies; support the development of local clinical leadership and expertise in respect of specialised services; support specialised clinical networks and clinical reference groups, including participating in development and agreement of the annual plan for relevant clinical networks; and work with providers as commissioners of specialised services, including management of contracts and the annual contracting round, financial management, and working with providers on identification and management of any issues relating to quality of services.
Appropriate oversight and assurance arrangements are in place to assure the commissioning capability and capacity of ICBs, and so that NHS England, as the accountable commissioner, has the right mechanisms where support or intervention is needed, regardless of whether a service is retained by NHS England or falls within scope of delegated commissioning arrangements.
Asked by: Karin Smyth (Labour - Bristol South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether she has made an assessment of progress in the development of a clinical analytical service for specialised commissioning.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
Commissioners of Specialised Services have access to the analysis of clinical data via their regional business intelligence teams, or the nationally commissioned Commissioning Support Unit (CSU) service provision.
Routine reporting can be accessed via the National Commissioning Data Repository, and more focused analytics can be performed across commissioning and clinical datasets collected by NHS England. NHS England has developed 181 Specialised Services Quality Dashboards alongside service specifications, which provide additional data to monitor the quality of services and maintain clinical registries ranging from bowel cancer to pulmonary hypertension. The full list is available at the following link:
https://digital.nhs.uk/data-and-information/clinical-audits-and-registries
Asked by: Karin Smyth (Labour - Bristol South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what the annual running costs were for NHS (a) Arden and GEM, (b) Midlands and Lancashire, (c) North of England and (d) South, Central and West Commissioning Support Unit in the 2022-23 financial year.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department of Health and Social Care has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.
Asked by: Karin Smyth (Labour - Bristol South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment she has made of the potential imapct of delegating specialised services to Integrated Care Systems on continuity of care for patients.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The Department of Health and Social Care has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.
Asked by: Karin Smyth (Labour - Bristol South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment she has made of the potential impact of delegating specialised services to Integrated Care Systems on patient outcomes.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The Department of Health and Social Care has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.
Asked by: Karin Smyth (Labour - Bristol South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what engagement commissioning hub teams looking at specialised commissioning have with commissioning support units.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The Department of Health and Social Care has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.
Asked by: Karin Smyth (Labour - Bristol South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to Annex A of the NHS publication entitled Specialised Commissioning – update on specialised services for delegation, published on 28 March 2024, whether she plans for the 32 specialised services retained by NHS England from April 2025 to be (a) delegated or (b) retained in perpetuity.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The Department of Health and Social Care has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.
Asked by: Karin Smyth (Labour - Bristol South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment she has made of the potential impact of joint commissioning on the 59 specialised services approved by the NHS England Board in February 2023.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The Department of Health and Social Care has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.
Asked by: Karin Smyth (Labour - Bristol South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment has she made of the adequacy of the progress towards full delegated commissioning for Integrated Care Boards by April 2025 in (a) the South West, (b) the South East, (c) London and (d) the North East.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The total spend on commissioning specialised services was £22.7 billion in 2022/23 and £25 billion in 2023/24. As formal delegation of specialised services to integrated care boards (ICBs) begins from 1 April 2024, all spend on commissioning these services in previous years has been the responsibility of NHS England, and not the ICBs. For 2024/25, NHS England is delegating £5.3 billion of commissioning resource to ICBs in the three regions, where delegation will begin from April 2024. This figure excludes high-cost drugs and devices spend.
The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between the ICBs and NHS England regional teams, followed by a National Moderation Panel, and final decision taken by the NHS England Board. The NHS England Board papers for February 2023, December 2023, and March 2024 are available, respectively, at the following links:
The process concluded that a transitional year of joint commissioning would offer the most secure and stable transition towards delegation. There is a comprehensive programme structure in place to support the ICBs in the four regions that are working towards delegation in April 2025, to support them in being ready to take on the responsibilities. NHS England is continuing to work alongside ICBs to ensure that delegation agreements are in place, including ensuring appropriate collaborative arrangements are developed to support ICB commissioning of specialised services. These arrangements will be monitored by NHS England through its assurance processes for specialised services.
A webinar series for commissioning staff, including colleagues in ICBs, was delivered in 2023 across different aspects of specialised services, and there are additional webinars planned in 2024. There has been, and will continue to be, local engagement between regional commissioning teams and ICB teams, as the future operating model is co-developed. A suite of support materials has been shared with teams and continues to be updated. As examples, these include: Commissioning Change Management Business Rules; Finance and Accounting Standard Operating Procedure; and the Contracting Standard Operating Procedure.
NHS England develops services specification and clinical policies through its Clinical Reference Groups. There are 250 published service specifications which include clinical pathway, quality, and other relevant standards, which are specific to the clinical service. Regional commissioning teams, overseen by the statutory joint committees, are responsible for implementing the specifications in their commissioning of services, along with assessing compliance against national standards. NHS England has developed Specialised Services Quality Dashboards alongside service specifications, which provide additional data to monitor the quality of services.