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, how much each NHS Integrated Care Systems owed to NHS England for historic deficits at the end of the 2023-24 financial year.
Answered by Andrew Stephenson
The final year-end financial position for the integrated care boards, National Health Service trusts, and foundation trusts has not yet been finalised. All figures are due to be audited and will be reported in the accounts for all organisations, as well as in the Department’s 2023/24 Annual Report and Accounts, to be published later this year.
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, how many NHS (a) integrated care systems and (b) trusts were in deficit at the end of the 2023-24 financial year; and if she will publish a breakdown of those figures by (i) acute, (ii) mental health, (iii) community health, (iv) ambulance services and (v) other types of trust.
Answered by Andrew Stephenson
The final year-end financial position for the integrated care boards, National Health Service trusts, and foundation trusts has not yet been finalised. All figures are due to be audited and will be reported in the accounts for all organisations, as well as in the Department’s 2023/24 Annual Report and Accounts, to be published later this year.
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 overall year end deficit for integrated care systems was in the financial year 2023-24.
Answered by Andrew Stephenson
The final year-end financial position for the integrated care boards, National Health Service trusts, and foundation trusts has not yet been finalised. All figures are due to be audited and will be reported in the accounts for all organisations, as well as in the Department’s 2023/24 Annual Report and Accounts, to be published later this year.
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, in how many NHS trusts temporary buildings are in use.
Answered by Andrew Stephenson
The National Health Service does not hold data on the number of temporary buildings in use.
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 - Shadow Secretary of State for Work and Pensions
The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between integrated care boards (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. NHS England is working 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.
On 28 March 2024, the NHS England Board approved the recommendation that the 32 specialised services listed in Annex A of Item 7 of Specialised Commissioning: update on specialised services for delegation, would be retained by NHS England.
Regardless of delegation status, NHS England will remain the accountable commissioner for the entire portfolio of specialised services, and as part of this role, will monitor the effectiveness of delegation and the lists of services. It should be noted that NHS England does have the ability to bring a service back under national commissioning control, under the safeguards put in place to support delegation.
All specialised services, whether retained or delegated, must comply with nationally developed standards, including service specifications and clinical commissioning polices. ICBs will be able to use specialised services funding to transform and develop services and pathways across their core and specialised responsibilities, to improve quality of care and equity of access and value, whilst also complying with national standards.
Whilst delegation is not an end in itself, moving to ICB-led commissioning supports a focus on population health management across whole pathways of care, and gives ICBs the powers they need to improve the quality of services, tackle health inequalities, and ensure best value. NHS England set out in detail the benefits of greater ICB involvement in the commissioning of appropriate specialised services in the Roadmap for Integrating Specialised Services within Integrated Care Systems, and subsequent board papers. This roadmap is available at the following link:
These plans have been developed in close collaboration with NHS England’s regional teams, ICBs, specialised service providers, clinicians, and patients, and represent the outcome of a thorough assessment of ICB system readiness, and a comprehensive analysis of services to determine their suitability and readiness for more integrated commissioning. During 2024/25, specialised services commissioning teams will remain employed by NHS England. NHS England has a framework for commissioning support, and accesses a range of services from commissioning support units. For example, data and business intelligence, and programme and project management expertise and resources.
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 - Shadow Secretary of State for Work and Pensions
The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between integrated care boards (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. NHS England is working 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.
On 28 March 2024, the NHS England Board approved the recommendation that the 32 specialised services listed in Annex A of Item 7 of Specialised Commissioning: update on specialised services for delegation, would be retained by NHS England.
Regardless of delegation status, NHS England will remain the accountable commissioner for the entire portfolio of specialised services, and as part of this role, will monitor the effectiveness of delegation and the lists of services. It should be noted that NHS England does have the ability to bring a service back under national commissioning control, under the safeguards put in place to support delegation.
All specialised services, whether retained or delegated, must comply with nationally developed standards, including service specifications and clinical commissioning polices. ICBs will be able to use specialised services funding to transform and develop services and pathways across their core and specialised responsibilities, to improve quality of care and equity of access and value, whilst also complying with national standards.
Whilst delegation is not an end in itself, moving to ICB-led commissioning supports a focus on population health management across whole pathways of care, and gives ICBs the powers they need to improve the quality of services, tackle health inequalities, and ensure best value. NHS England set out in detail the benefits of greater ICB involvement in the commissioning of appropriate specialised services in the Roadmap for Integrating Specialised Services within Integrated Care Systems, and subsequent board papers. This roadmap is available at the following link:
These plans have been developed in close collaboration with NHS England’s regional teams, ICBs, specialised service providers, clinicians, and patients, and represent the outcome of a thorough assessment of ICB system readiness, and a comprehensive analysis of services to determine their suitability and readiness for more integrated commissioning. During 2024/25, specialised services commissioning teams will remain employed by NHS England. NHS England has a framework for commissioning support, and accesses a range of services from commissioning support units. For example, data and business intelligence, and programme and project management expertise and resources.
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 - Shadow Secretary of State for Work and Pensions
The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between integrated care boards (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. NHS England is working 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.
On 28 March 2024, the NHS England Board approved the recommendation that the 32 specialised services listed in Annex A of Item 7 of Specialised Commissioning: update on specialised services for delegation, would be retained by NHS England.
Regardless of delegation status, NHS England will remain the accountable commissioner for the entire portfolio of specialised services, and as part of this role, will monitor the effectiveness of delegation and the lists of services. It should be noted that NHS England does have the ability to bring a service back under national commissioning control, under the safeguards put in place to support delegation.
All specialised services, whether retained or delegated, must comply with nationally developed standards, including service specifications and clinical commissioning polices. ICBs will be able to use specialised services funding to transform and develop services and pathways across their core and specialised responsibilities, to improve quality of care and equity of access and value, whilst also complying with national standards.
Whilst delegation is not an end in itself, moving to ICB-led commissioning supports a focus on population health management across whole pathways of care, and gives ICBs the powers they need to improve the quality of services, tackle health inequalities, and ensure best value. NHS England set out in detail the benefits of greater ICB involvement in the commissioning of appropriate specialised services in the Roadmap for Integrating Specialised Services within Integrated Care Systems, and subsequent board papers. This roadmap is available at the following link:
These plans have been developed in close collaboration with NHS England’s regional teams, ICBs, specialised service providers, clinicians, and patients, and represent the outcome of a thorough assessment of ICB system readiness, and a comprehensive analysis of services to determine their suitability and readiness for more integrated commissioning. During 2024/25, specialised services commissioning teams will remain employed by NHS England. NHS England has a framework for commissioning support, and accesses a range of services from commissioning support units. For example, data and business intelligence, and programme and project management expertise and resources.
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 - Shadow Secretary of State for Work and Pensions
The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between integrated care boards (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. NHS England is working 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.
On 28 March 2024, the NHS England Board approved the recommendation that the 32 specialised services listed in Annex A of Item 7 of Specialised Commissioning: update on specialised services for delegation, would be retained by NHS England.
Regardless of delegation status, NHS England will remain the accountable commissioner for the entire portfolio of specialised services, and as part of this role, will monitor the effectiveness of delegation and the lists of services. It should be noted that NHS England does have the ability to bring a service back under national commissioning control, under the safeguards put in place to support delegation.
All specialised services, whether retained or delegated, must comply with nationally developed standards, including service specifications and clinical commissioning polices. ICBs will be able to use specialised services funding to transform and develop services and pathways across their core and specialised responsibilities, to improve quality of care and equity of access and value, whilst also complying with national standards.
Whilst delegation is not an end in itself, moving to ICB-led commissioning supports a focus on population health management across whole pathways of care, and gives ICBs the powers they need to improve the quality of services, tackle health inequalities, and ensure best value. NHS England set out in detail the benefits of greater ICB involvement in the commissioning of appropriate specialised services in the Roadmap for Integrating Specialised Services within Integrated Care Systems, and subsequent board papers. This roadmap is available at the following link:
These plans have been developed in close collaboration with NHS England’s regional teams, ICBs, specialised service providers, clinicians, and patients, and represent the outcome of a thorough assessment of ICB system readiness, and a comprehensive analysis of services to determine their suitability and readiness for more integrated commissioning. During 2024/25, specialised services commissioning teams will remain employed by NHS England. NHS England has a framework for commissioning support, and accesses a range of services from commissioning support units. For example, data and business intelligence, and programme and project management expertise and resources.
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 - Shadow Secretary of State for Work and Pensions
The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between integrated care boards (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. NHS England is working 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.
On 28 March 2024, the NHS England Board approved the recommendation that the 32 specialised services listed in Annex A of Item 7 of Specialised Commissioning: update on specialised services for delegation, would be retained by NHS England.
Regardless of delegation status, NHS England will remain the accountable commissioner for the entire portfolio of specialised services, and as part of this role, will monitor the effectiveness of delegation and the lists of services. It should be noted that NHS England does have the ability to bring a service back under national commissioning control, under the safeguards put in place to support delegation.
All specialised services, whether retained or delegated, must comply with nationally developed standards, including service specifications and clinical commissioning polices. ICBs will be able to use specialised services funding to transform and develop services and pathways across their core and specialised responsibilities, to improve quality of care and equity of access and value, whilst also complying with national standards.
Whilst delegation is not an end in itself, moving to ICB-led commissioning supports a focus on population health management across whole pathways of care, and gives ICBs the powers they need to improve the quality of services, tackle health inequalities, and ensure best value. NHS England set out in detail the benefits of greater ICB involvement in the commissioning of appropriate specialised services in the Roadmap for Integrating Specialised Services within Integrated Care Systems, and subsequent board papers. This roadmap is available at the following link:
These plans have been developed in close collaboration with NHS England’s regional teams, ICBs, specialised service providers, clinicians, and patients, and represent the outcome of a thorough assessment of ICB system readiness, and a comprehensive analysis of services to determine their suitability and readiness for more integrated commissioning. During 2024/25, specialised services commissioning teams will remain employed by NHS England. NHS England has a framework for commissioning support, and accesses a range of services from commissioning support units. For example, data and business intelligence, and programme and project management expertise and resources.
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 - Shadow Secretary of State for Work and Pensions
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.