Note: Response submitted online by RCPE.
Introduction
1. Before April 2013, commissioning specialised services for the population of England was largely the responsibility of Primary Care Trusts. They acted together in geographical groupings to cover populations of a size more suited for the planning and commissioning of services that typically involve relatively few service providers, relatively small numbers of patients and sometimes unpredictably high costs.
2. From April 2013, NHS England became responsible for commissioning specialised services as defined in Schedule 4 to the National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing rules) Regulations 2012. Commissioning these services at a national level brought the opportunity to achieve a greater consistency and quality of care, through the implementation of national service specifications and clinical policies.
3. NHS England’s specialised services portfolio currently costs about £14bn each year, with pressure for substantial growth in activity and costs year on year.
4. This consultation document therefore sets out a proposed set of principles which will underpin the future decision making process for investment in specialised services. It also outlines the process that NHS England will use to make these decisions.
Why we are consulting
5. NHS England is committed to ensuring all patients have access to consistent high quality, effective, efficient services that represent value for money, meet the needs of our diverse populations and are sustainable in the longer term.
6. In conducting a full public consultation, NHS England is seeking to ensure that the principles and process for making decisions on investing in specialised services are well informed, evidence-led and in line with the expectations of patients and the public.
7. NHS England seeks to comply with the best practice consultation principles issued by the Cabinet Office in 20121.
8. NHS England seeks to remain open, engaged and transparent throughout the process for discharging its responsibilities for the direct commissioning of specific health services.
9. NHS England is committed to promoting equality and reducing health inequalities throughout the health service. Consultation provides the opportunity to gain information about any potential impact on health inequalities which might arise as a result of new or changed processes for making decisions about health services that are directly commissioned by NHS England. This information will feed into an Equality and Health Inequalities Analysis on this programme of work.
Scope of the consultation
10. The principles and process set out in this consultation applies only to the specialised acute and mental health services that are directly commissioned by NHS England.
11. Processes for making decisions about the health services that are directly commissioned by Clinical Commissioning Groups2 are outside the scope of this consultation. This reflects the separation of commissioning responsibilities across NHS England and Clinical Commissioning Groups. Primary care services, public health services, health and justice services and health services for the armed forces are also outside of the scope of this consultation.