Specialised Commissioning

Specialised Commissioning Service Development Policy | NHS England

This service development policy  sets out NHS England’s approach for making decisions about which new treatments and interventions to routinely commission, and the approach used for updating existing service specifications, or creating new ones.

It is intended to ensure that funding is allocated fairly and appropriately, with due
regard to the competing demands on NHS England’s available funding.

This policy is accompanied by two methods documents: Methods: National Clinical
Policies and Methods: Service Specification which set out the processes in detail.


Early benefits of delegated commissioning

NHS England have produced a series of Delegated commissioning case studies to show how CCGs are using delegated commissioning to improve care for local people. 


CCGs have reported that delegated commissioning is leading to:

  • The development of clearer, more joined up visions for primary care, aligned to wider CCG and STP plans for improving health services;
  • Improved access to primary care;
  • Improved quality of care being delivered to patients;
  • Improved CCG relationships with member practices, including greater local ownership of the development of primary care services;
  • Increased clinical leadership in primary care commissioning, enabling more local decision making;
  • Greater involvement of patients in shaping services;
  • A more sustainable primary care system for the future.

NHS England have produced a series of case studies to show how CCGs are using delegated commissioning to improve care for local people:

Patient insight guides


NHS England has published two further bite-size guides to patient insight to help CCGs and providers make better use of national surveys and feedback data:

  • How and when to commission new insight and feedback – explains the role of insight, the different kinds that can be used to build a reliable picture and how to commission new insight work through suppliers
  • Insight – what is already available – provides an overview of the different types of information available and brief explanations of how they can be used.

NHS England announces £101 million of new funding for new care model vanguards

£101 million of new funding to support and spread the work of the new care model vanguards | NHS England


The vanguards are partnerships of NHS, local government, voluntary, community and other organisations that are implementing plans to improve the healthcare people receive, prevent ill health and save funds.

Considerable progress has been made since the vanguards were launched in 2015 and there is emerging evidence that they are making significant improvements at a local level. This includes reducing pressure on busy GP and A&E services.

In addition to the funding, the vanguards will continue to receive support from NHS England and other national bodies to implement their plans, including how they harness new technology including apps and shared computer systems. They are also receiving help to develop their workforce so that it is organised around patients and their local populations.

Read the full overview here

Commissioner Guidelines for Responding to Requests from Practices to Temporarily Suspend Patient Registration

These guidelines have been published to assist commissioners in responding to practices wanting to suspend patient registration on a temporary basis | NHS England

Image source: NHS England

It recognises the duty on commissioners to secure services for patients as well as the pressure on practices in providing services linking with support arrangements described in the general practice forward view.

The GMS and PMS contracts allow for a Practice to request permission from its commissioner to close its list to new patients (Paragraph 29 of Schedule 6, Part 2 of the NHS (GMS Contracts) Regulations (as amended). This option exists to give practices a degree of workload control over the management of their services, particularly when there is unusual and sustained demand from patients or in situations of workforce or recruitment difficulties that affect a practices ability to provide services to an acceptable and safe standard.

Read the full document here

2017/18 NHS standard contract

The NHS Standard Contract is mandated by NHS England for use by commissioners for all contracts for healthcare services other than primary care.

Image source: NHS England

The Contract (in full-length and shorter-form versions) has now been updated from the 2016/17 to the 2017/18 – 2018/19 version. A summary of the changes we have made to the Contracts can be found in section 3 of the NHS Standard Contract Technical Guidance and in the Summary of key changes documents below.

The full –length NHS Standard Contract 2017/18-2018/19 comprises three parts:

The NHS shorter-form Contract 2017/18-2018/19 also comprises three parts:

Read the full NHS Standard Contract 2017/18 and 2018/19 Technical Guidance here

Read the full overview here

Procedures for clinical commissioning groups to apply for constitution change, merger or dissolution

NHS England | Published online: 3 November 2016

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This document supersedes Procedures for clinical commissioning group constitution change, merger or dissolution published in October 2015, and should be used by Clinical Commissioning Groups (CCGs) and NHS England in the circumstances of a CCG wishing to apply to NHS England to make changes to its constitution or to dissolve two or more CCGs wishing to apply to merge.

The procedures in this guidance set out the application processes to be followed by CCGs and NHS England in considering the request.

This guidance sets out NHS England’s procedure and how it is underpinned by the requirements of the National Health Service Act 2006 (as amended) (“the NHS Act 2006”) and by relevant regulations.

Under the NHS Act 2006, NHS England has powers to make transfers of property and staff in connection with variation, merger, or dissolution. The use of these powers is included in the scope of these procedures.

NHS England has separate powers which allow it to vary a CCG’s area or membership without an application from the CCG. The application of this power is out of scope of the procedures outlined in this guidance. In all cases CCGs considering changes to constitutions under these procedures are advised to discuss their applications with NHS England at an early stage.

Read the full report here