1. Presentation heading Presented by / Sub-heading Commissioning Explained Sarah Freeman Local Service Specialist – West Midlands Team

2. NHS Values Working together for patients Compassion Commitment to Quality of Care Respect and dignity Improving lives Everyone counts NHS | Presentation to MS EAG | 10 th October 20142

3. Health and Social Care Act 2013 Move to clinically led commissioning Increase in patient involvement Renewed focus on the importance of public health Streamlining of “arms–length” bodies Allowing healthcare market competition in the best interest of patients NHS | Presentation to MS EAG | 10 th October 2014 3

4. Finances Money for the NHS comes from the Treasury, mostly via taxation. Every 2-3 years the Treasury holds a Spending Review setting budgets for all major public services. Health receives around £107 billion a year. Nearly half the NHS budget is spent on acute and emergency care. 10% goes on each of General Practice, Community Care, Mental Health and Prescribing 10% remaining health commitments – Public Health, Offender Health, running costs etc. CCG budgets are set on population size, adjusted for age, health and location Money is paid to providers by a combination of Payment by Results (PbR), block contracts and local variations. This is working towards a payment system based on quality of care and health outcomes. NHS | Presentation to MS EAG | 10 th October 20144

5. Money Flows from the Treasury to Patient Services Money flows from the Treasury to the Department of Health which retains a proportion for its running costs and funding bodies such as Public Health England. Department of Health allocates approx. £96 billion p.a. to NHS England. Approx. £30 billion is retained to pay for running costs and directly commissioned services - primary care, specialised services, offender and military health care. The remaining £64 billion is passed onto clinical commissioning group (CCGs) to enable them to commission services for their populations NHS | Presentation to MS EAG | 10 th October 2014 5

6. Commissioning: NHS England NHS England was formally established as the NHS Commissioning Board in October 2012. It’s main aim is to improve health outcomes and deliver high quality care by: Providing national leadership for improving outcomes and driving up the quality of care Overseeing the operation of CCGs Allocating resources to CCGs Commissioning primary care and directly commissioned services 4 Regional Teams, 27 Local Area Teams (ATs), 10 with responsibility for specialised services NHS | Presentation to MS EAG | 10 th October 20146

7. Setting the Agenda: CRG’s  Specialised Services Clinical Reference Groups (CRGs) have been established to cover the full range of specialised services defined within the Specialised Services National Definition Set (SSNDS) portfolio.  CRGs aim to ensure clinical and patient led development and delivery of commissioning products for the national commissioning of prescribed services by NHS England. The CRGs will be the key delivery mechanism for the development and assurance of specialised services contracts products during 2013/14 required for 2014/15 contracts and beyond.  Each CRG has an identified ‘core’ set of products to develop in 2013/14 with a defined timeline for completion

9. Local Delivery of Specialised Services Ten Areas Teams: contract and performance management of activity, products, implementation and compliance of service specifications hold a single NHS England contract with providers in their area for all specialised services (including Highly Specialised) be responsible for oversight of time-limited derogation from the national service specifications where required by local services All Area Teams: lead on local delivery of national standards and policies and contracting be the hub for local knowledge ensuring local expertise on services, and strong relationships with local stakeholders deliver integration in patient pathways with CCGs and other commissioning bodies ensure local engagement and communication with Clinical Senates, Strategic Clinical Networks, Operational Delivery Networks and providers

10. Commissioning: CCGs CCGs are designed to be clinically led and responsive to the health needs of their local populations. They are made up of GP practices in the area they cover. There are 211 CCGs with a median population of 250,000 They commission from a range of providers for: Urgent and emergency care Elective hospital care Community health services Maternity and new born Mental health and learning disabilities NHS | Presentation to MS EAG | 10 th October 201410

11. Support for Commissioners: Commissioning Support Units (CSU)  Transactional commissioning – market management, contract negotiation, information and data analysis  Transformational commissioning – supporting service redesign NHS | Presentation to MS EAG | 10 th October 2014 ]11

12. Support for Commissioners: Strategic Clinical Networks Focus on priority areas to improve equity, quality of care, and health outcomes. Bring together providers and commissioners to support more effective service delivery, Cardiovascular Maternity, children and young people Mental health, dementia and young people Cancer NHS | Presentation to MS EAG | 10 th October 2014 ]12

13. Support for Commissioners: Clinical Senates Multi-professional advisory groups of experts from across health and social care. 12 clinical senates across England. Source of independent, strategic advice and guidance to commissioners and other stakeholders to assist decision making Comprised of a core Clinical Senate Council and wider Clinical Senate Assembly or Forum NHS | Presentation to MS EAG | 10 th October 2014 13

14. Useful Links Web link for specialised commissioning and key documents http://www.england.nhs.uk/wp- content/uploads/2014/06/simple-nhs-guide.pdf http://www.england.nhs.uk/resources/spec-comm- resources/ http://www.england.nhs.uk/npc-crg/ http://www.england.nhs.uk/ourwork/d-com/spec- serv/crg/