Specialised Commissioning Alert: Integrated Care Systems

22 July 2021

A letter confirming the intention to delegate some of NHS England and NHS Improvement’s direct commissioning functions to integrated Care Boards (ICBs) as soon as operationally feasible from April 2022.
A timeline is given for transition of responsibility for primary care services (medical, dental, general ophthalmic and pharmaceutical services), direct commissioning, specialised services and public health services.
By April 2023 ICBs are expected to take on delegated commissioning responsibility for a proportion of specialised services. NHS E/I will retain responsibility for specialised services that need to be centrally commissioned.

12 February 2020

HSJ Intelligence briefing 12 February 2020 [Subscription required]

Extract:
Specialist commissioning

NHS England is already in the process of devolving some of its specialised commissioning responsibilities for mental health to groups of NHS providers. It is looking at extending this approach to physical health services.
The first contracts to be devolved to ICSs could be for kidney dialysis as well as parts of cancer treatment. However, ICSs are resistant to taking on these responsibilities until NHSE can quantify the need within the local populations, as otherwise it is felt the financial risk is too great.
However, if this tension is to be resolved in 2020, it may need NHSE to initially share the financial risk with ICSs.
In its 2020-21 planning guidance, NHSE announced its intention to review how payments for specialised commissioning are designed and implemented.
It also now expects specialised commissioning income plans for ICSs to be closer aligned with NHSE specialised commissioning budgets. Local systems will likely have to change the way they deliver services to drive the specialised commissioning efficiencies needed.
This may well see increased consolidation of specialised commissioning services on a reduced number of sites.

Frailty