NHS Specialised Services inquiry
Closed
What the inquiry looked at
“Specialised services in the NHS are those provided in relatively few hospitals, accessed by comparatively small numbers of patients but with catchment populations of more than one million. These services tend to be located in specialised hospital trusts that can recruit a team of staff with the appropriate expertise and enable them to develop their skills Specialised services account for approximately 13% of the total NHS budget, spending circa £14.7 billion per annum (2015–16). The commissioning of specialised services is a prescribed direct commissioning responsibility of NHS England Four factors determine whether NHS England commissions a service as a prescribed specialised service. These are: The number of individuals who require the service; The cost of providing the service or facility; The number of people able to provide the service or facility The financial implications for Clinical Commissioning Groups (CCGs) if they were required to arrange for provision of the service or facility themselves. There are over 140 specialised services, covering a diverse range of disparate and complex services from long-term conditions, such as renal services, specific mental health problems, to rarer conditions such as uncommon cancers, burn care, medical genetics, and paediatric cardiac surgery. The National Audit Office (NAO) are currently examining whether NHS is delivering value for money in the commissioning of specialised services. It will examine whether NHS England has a delivery plan to implement its strategy for the commissioning of these services; whether NHS England is commissioning these services effectively; and whether NHS England is able to gain assurance that these services are being delivered efficiently and effectively in line with its objectives for patient outcomes and access to services.”
The committee's words, from the inquiry page on parliament.uk ↗.
What it found
Over the last three years spending on specialised services has increased at a faster rate (6.3% a year) than the NHS as a whole (3.5% a year) and now accounts for about 14% of the total NHS budget. We are concerned that, despite the large increase in the budget for specialised services, NHS England has not kept its spending within the budget it set itself. The disproportionate growth in spending on specialised services poses a corresponding risk to financial sustainability of the wider NHS and, if NHS England is unable to keep its spending on these services in control, this will affect its ability to resource other health services and wider health transformation set out in its Five Year Forward View. To remain within its budget for specialised commissioning, NHS England will need to make tough decisions. These include taking action in three areas:
(a) ensuring new drugs and medical equipment are affordable; (b) ensuring services are delivered cost-effectively; and (c) better management of the level of demand for the specialised services it commissions. When taking action to control its spending on specialised services, NHS England also needs to work closely with NHS acute providers to avoid adding undue pressures to their budgets. We recognise that it is challenging to commission such a wide range of complex services while funding is becoming increasingly tight. However, we are concerned that NHS England and the Department of Health painted an unduly healthy picture of the state of commissioning specialised services in England. It is disappointing that, after three years, NHS England still does not have consistent information from all providers on costs, access to services and outcomes, or how efficiently services are being delivered. Without this information it cannot manage the ongoing pressure on its budget, make effective strategic decisions or gain assurance that its objectives for these services are being met.
What the government said
No government response is linked to this report.
How the inquiry ran
Each dot is a dated item listed on this page, from the inquiry's opening on 13 April 2016 to its close on 4 January 2018.
- Oral evidence 9 May 2016
- Report 15 Jul 2016
What it recommended
The committee's recommendations are not listed here yet. Read them in 10th Report - NHS specialised services ↗ on parliament.uk.
Evidence
Oral evidence sessions 1
- 9 May 2016No witnesses recordedparliament.uk ↗