Local scrutiny

Accepted.
Commissioners must develop plans to ensure that safe and effective services can continue to be provided in the event of a provider failure.
NHS England is supporting commissioners to develop plans for responding to a serious provider failure, in line with Monitor’s guidance and rules on service continuity.
The Department of Health, the Care Quality Commission, NHS England, Monitor and the NHS Trust Development Authority are working together to develop a single failure regime (outlined in the response to recommendation 19), which will ensure that financial and quality failures are handled in a consistent way and can be enacted where risks to quality and patient safety are identified. As part of that regime, the Care Quality Commission, NHS Trust Development Authority and Monitor will work together, with the trust and its commissioners, to ensure that where concerns are raised, the trust acts swiftly to resolve them. This will provide external support and assurance that appropriate action has been taken or may indicate that further action is needed.

NHS England published the NHS Oversight Framework to identify where Integrated Care Boards (ICBs) and/or NHS providers may benefit from, or require, support; and provide an objective basis for decisions about when and how NHS England will intervene. These decisions take into account factors including organisational and system context and an assessment of leadership and governance.

NHS England discharges its duties in collaboration with ICBs; agreeing together the specific arrangements for each system to ensure effective and proportionate oversight, reflecting local delivery and governance arrangements.

National guidance on system quality groups (SQGs), was issued in January 2022. SQGs provide a strategic forum to facilitate engagement, intelligence-sharing, learning and quality improvement between all organisations within an integrated care system. Where the services are such that they would need to remain in their area if a provider were to get into difficulty because:
• there is no alternative provider close enough
• and/or removing them would increase health inequalities
• and/or removing them would make dependent services unviable. Or if the Provider has been designated as a hard to replace provider then the Continuity of Service conditions set out in the NHS Provider Licence will apply.

With support from NHS England, many commissioners have developed plans for responding to a serious provider failure, in line with Monitor’s service continuity guidance. All clinical commissioning groups will be required to have these plans in place by 2015/16.

This recommendation was accepted by the Government.

In the January 2014 Hard Truths report, the Government said that NHS England was support commissioners in developing plans for responding to serious provider failure.

In the February 2015 Culture Change report, the Government said that many commissioners had developed plans for responding to a serious provider failure, with all clinical commissioning groups