Delegation of Commissioned Services in Midlands
The delegation of commissioned services in Midlands is set to transfer responsibilities to Integrated Care Boards, aiming for better local healthcare delivery. This shift aims to improve services and resources allocation, enhancing patient care and promoting collaboration over competition for comprehensive healthcare solutions.
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The delegation of commissioned services and what it means for you January 2023 JOINING UP HEALTH & CARE IN THE MIDLANDS
Where we are now In three months the pharmacy, optometry and dental services currently commissioned by NHS England regionally will be delegated to Integrated Care Boards (ICBs) The boards in each system will be responsible for the pharmacy, optometry and dental service given to people in their areas Through East and West Midlands Joint Commissioning Boards, systems will be able to plan and execute the services needed for local populations with money that they will hold directly In a year s time, other services commissioned directly by NHS England in the Midlands will also be delegated for instance some specialised services such as kidney and cardiac services. 2 NHS England Joining Up Health & Care in the Midlands
The background The Health and Care Act of 2022 saw the creation of 11 ICBs in the Midlands, with statutory authority to plan and deliver healthcare more locally In July 2022, primary medical services (GPs) were delegated to ICBs (in reality these services had previously been delegated to CCGs) The aim is to achieve: better health for everyone better care for all patients efficient use of NHS resources locally and nationally support to broader social and economic development 3 NHS England Joining Up Health & Care in the Midlands
Articulating the benefits Society s health and care needs are changing. People are living longer, new medicines and technologies are being discovered and more of us are living with long-term conditions such as diabetes and asthma We need services that understand these increasingly complex needs, and can treat us as individuals Old divides between hospitals and family doctors, between physical and mental health and between NHS and council services, mean that too many people experience disjointed care. They may have to repeat the same details to several people in different NHS organisations. This is bad for them and not a good use of staff s precious time Commissioning locally takes away the competitive element collaboration is key not competition. 4 NHS England Joining Up Health & Care in the Midlands
What delegation might mean Development of engagement with patients and public to include services that are delegated Closer working with local authority public health and scrutineers around pharmacy, optometry and dental services as well as other services once delegated Involvement of all providers primary care, secondary and tertiary care plus public health, local authorities and voluntary organisations in the development of care Development of services to better reflect the needs of local populations for instance perhaps more children s services or more for older populations Local systems being responsible for all areas of a pathway from diagnostics to inpatient treatment and after care 5 NHS England Joining Up Health & Care in the Midlands
How will delegation work in each ICB? To ensure the benefits of more localised strategy while balancing economies of scale, each of the 11 ICBs will delegate back the running of pharmacy, optometry and dental services to East Midlands and West Midlands multi-ICB and NHS England Joint Committees East Midlands Multi-ICB & NHSE Joint Committee West Midlands Multi- ICB & NHSE Joint Committee These will set strategy and hold the commissioning authority The majority of decisions will be discharged through sub groups: POD Joint Commissioning Groups in both East and West Midlands, with representatives of each ICB sitting on them 6 NHS England Joining Up Health & Care in the Midlands
How will delegation work The East and West Multi-ICB and NHSE Joint Committees will also set the strategy and hold the commissioning authority for other services to be delegated for instance those specialised services to be delegated in 2024 and other ICB led joint services such as 999 and 111 7 NHS England Joining Up Health & Care in the Midlands
Where is the workforce? Teams that currently commission and manage pharmacy, optometry and dental services for NHS England in the Midlands will continue in their work, but will be directed by the ICB POD Joint Commissioning Group To do this, they will transfer to ICB host organisations later this spring In the East Midlands this recommended host is NHS Nottingham and Nottinghamshire ICB In the West Midlands this recommended host is NHS Birmingham and Solihull ICB Teams that currently commission and manage specialised services will also transfer to a host ICB when these services are delegated. This will be a single host for the Midlands, and it is recommended this is NHS Birmingham and Solihull ICB 8 NHS England Joining Up Health & Care in the Midlands
What is happening now primary care All 11 ICBs are proceeding to assume delegation of pharmacy, optometry and dental services in April 2023 Business intelligence and data around the planning of each service is being shared with ICBs by NHS England Finance information is being shared in advance of budgets moving to ICBs in April 2023 Professional network leaders are engaged and involved Clinical and quality leads are discussing processes In depth discussions are taking place with recommended ICB hosts around the working arrangements for staff transferring Recommendations on governance and ICB hosts are being taken to ICB and NHS England board meetings for approval 9 NHS England Joining Up Health & Care in the Midlands
What is happening now specialised services The Pre-Delegation Assessment Framework has been signed by all 11 ICBs and has been approved by the Regional Support Group and the National Moderation Panel. It will go to NHS England board this month There is a Specialised Acute and Pharmacy services commissioning working group to develop the operational governance processes that has representatives of ICBs and NHS England on it Business intelligence and data is being shared to help planning and a library of information developed Finance information is being shared 10 NHS England Joining Up Health & Care in the Midlands
What else has been achieved so far? The Collaborative Clinical Executive Forum has been established and meets monthly It brings together Acute Chief Medical Officers and ICB Chief Medical Officers to develop collaborative responses around areas where there are inequities or general poor outcomes eg: Inequity of outcomes and access for women with gynaecological cancer Finding a digital solution to maximise the effectiveness of pre anaesthetic management for paediatrics 11 NHS England Joining Up Health & Care in the Midlands
How can we help? Twice monthly updates on system comms leads calls Delegation updates issued every 7-10 days Internal news item for ICBs (attached) Stakeholder news item for ICPs (attached) 12 NHS England Joining Up Health & Care in the Midlands
