SHCA comments on specialised commissioning reform

On 1 April 2023, NHS England (NHSE) and Integrated Care Boards (ICBs) formed nine statutory joint committees to commission 59 specialised services deemed suitable and ready for greater ICB leadership – this includes most specialist cancer services, most specialist renal services and most specialist neurosciences services for adults. This next year is seen as a “stepping stone” towards full delegation of appropriate specialised services to ICBs from April 2024.

The SHCA supports NHSE’s aims to deliver more joined up care to patients and give local health systems more flexibility over how they use their budgets to meet the needs of their local population. The SHCA also welcomes NHSE’s phased approach to delegation: it was originally intended that full delegation of appropriate specialised services to ICBs would take place from April 2023, but having a transition year provides an important opportunity for further engagement with patient organisations and the wider healthcare community. 

In the year ahead, the SHCA is particularly keen to see action in the following areas:

• NHSE should share a list of service specifications that it intends to update in 2023/24, as well as explaining how it will monitor the safety and quality of services that have out-of-date or unclear national standards
• NHSE should publish detailed oversight and assurance arrangements that clearly explain the different responsibilities of the NHSE national team, NHSE regional teams, ICBs and providers, and the steps that will be taken if poor performance is identified 
• NHSE should continue to involve patient organisations in everything it does, and set out clear expectations for how ICBs should involve patients and the public in delegated decision-making
• NHSE should repeat and publish its assessment of ICB readiness before making a decision on whether to proceed with the full delegation of appropriate specialised services to ICBs from April 2024

We are grateful for NHSE’s engagement with the SHCA over the past year and we look forward to continuing to support the development of a new commissioning model for specialised services. 

If you would like to learn more about specialised commissioning reform, you can read the SHCA’s recently published Guide to specialised commissioning in 2023/24.