Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what progress has been made in ensuring that NHS England's definitions of commissioning responsibilities have been applied consistently across the country; and what assessment he has made of whether steps to ensure the consistency of such definitions will be complete by April 2015.

NHS England has advised that the guidance document ‘Who Pays? Determining responsibility for payments to providers’ defines which clinical commissioning group (CCG) is the responsible commissioner for an individual patient, or whether it is a CCG or NHS England.

In the case of any dispute regarding who should be the responsible commissioner, the Who Pays? guidance sets out that NHS England expects that all disputes will be resolved locally, ideally at CCG level, with reference to the guidance in the document and coming to pragmatic solutions where responsibility is not immediately obvious or where it may be shared. In cases that cannot be resolved at CCG level, area teams of NHS England should be consulted and arbitrate where necessary.

NHS England also produces the Manual for Prescribed Specialised Services. This is a technical document which describes commissioning responsibilities for prescribed specialised services. Some elements of these are to be directly commissioned by NHS England and some are to be commissioned by CCGs. It gives details of each service to be commissioned and a rationale as to why a service is to be commissioned by NHS England and not by CCGs.

NHS England has undertaken an internal audit to ensure consistency of application against the Manual for Prescribed Specialised Services. An action plan is in place to resolve issues identified through the audit relating to the application of the Manual for Prescribed Specialised Services and subsequent contracting tools.

A copy of the ‘Who Pays?’ document and a copy of the Manual for Prescribed Specialised Services 2013/14 are attached.