Resources for scrutiny

Accepted.
The NHS Standard Contract, NHS England’s assurance of clinical commissioning groups, and the development of commissioning support services, together provide a new infrastructure to ensure that commissioners have the capacity and capability to scrutinise providers’ services.
The NHS Standard Contract provides a clear framework through which commissioners can hold providers to account for service quality and safety, and NHS England will continue to develop this further for 2014–15.
Commissioning comprises some activities for which the statutory commissioning body must retain ultimate responsibility, but there is also a range of other, key support functions which it may be more effective and efficient to be secured externally. These are known as ‘commissioning support services’. Commissioning support services typically include:
• Health Needs Assessment;
• business intelligence;
• support for redesign;
• communications and patient and public engagement;
• procurement and market management (agreeing contracts);
• provider management (monitoring contracts).
Provision of commissioning support services is currently dominated by 19 commissioning support units, created from Primary Care Trusts and hosted by NHS England and the NHS Business Services Authority until 2016.
Work has already been done through NHS England’s clinical commissioning groups assurance programme and through the development of commissioning support services to assure the quality of infrastructure and support within, and available to, commissioning organisations. NHS England will continue to develop this as an objective in its Commissioning Support Services Strategy.

All NHS Commissioners have teams whose role it is to monitor the delivery of contracted services, including levels of access, quality of care purchased and clinical outcomes.

There are robust oversight and assurance mechanisms in place for delegated specialised commissioning services, including in respect of quality relation to services delegated by NHS England to ICBs.

The NHS Standard Contract is published and mandated for use by NHS England to commissioners of non-primary care healthcare services as the basis for sound and robust local contracts.

See answer to Recommendation 17 above for a selection of quality and oversight-related requirements in the contract

See response to recommendation 18 and 31 on the Quality Boards and Groups currently in place.

The NHS Standard Contract continues to provide a clear framework through which commissioners can hold providers to account for quality and safety. Revised provisions, particularly relating to commissioner’s rights to suspend the provision of services, were published in December 2013 as part of the NHS Standard Contract for 2014-15.

NHS England has developed a new framework agreement for commissioning support services – the Lead Provider Framework – that from January 2015 will give clinical commissioning groups, NHS England and other customers a choice of supplier for some or all of their commissioning support needs, ranging from transactional back office support services to more bespoke services that support local and large scale transformational change projects. The Framework will be available to any organization, within or outside the NHS that wishes to procure some or all of its health and social care support services from a variety of accredited providers. It is anticipated that between £3bn and £5bn of services will be procured through it over the next four years. Use of the framework is optional for clinical commissioning groups.

This recommendation was accepted by the Government.

In the January 2014 Hard Truths report, the Government said that the NHS Standard Contract, NHS England’s assurance of clinical commissioning groups and the development of commissioning support services provided an infrastructure to ensure that commissioners had the capacity and capability to scrutinise providers’ services. In the February 2015 Culture Change report, the Government said the NHS Standard Contract continued to provide this framework, with revised provisions relating to commissioner’s rights to suspend the provision of services being included in the NHS Standard Contract for 2014-15.