Planning, assuring and delivering service change for patients

NHS England  | April 2018  |Planning, assuring and delivering service change for patients

NHS England has published guidance for commissioners on substantial service change. This guidance has been designed to support commissioners and providers to consider how to take forward their proposals, including effective public involvement, enabling them to reach robust decisions on change in the best interests of their patients. It also  mentions some of the key considerations for commissioners and their partners in designing service change and in reconfiguration.

Clinical Commissioning Groups (CCGs) are under a statutory duty to have regard to this guidance. According to NHS England, by following this guidance, commissioners may reduce the risk of their service changes being referred to the Secretary of State, Independent Reconfiguration Panel or challenged by judicial review. By following the process set out below and appropriately and effectively involving local diverse communities, local authorities, key stakeholders and expert review (for example from Clinical Senates), later challenge may be avoided. (NHS England)

The full guidance can be downloaded from NHS England


Commissioning continuing healthcare

This document outlines key learning points from CCGs that have achieved significant  efficiency savings and improvements for patients in the provision of NHS continuing healthcare services in their local area | NHS Clinical Commissioners 

NHS continuing healthcare: Effective commissioning approaches identifies six national actions that will support the local delivery of Continuing Healthcare (CHC):

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  1. Recognise and value the CHC workforce
  2. Develop a clear national CHC narrative
  3. Develop a pre-checklist process to help address workload pressures
  4. Develop national guidance that supports local process
  5. Establish a national process for sharing legal advice where appropriate between CCGs
  6. Establish a policy feedback forum to ensure effective links with the reality of delivery on the ground

Full reference: NHS continuing healthcare: effective commissioning approaches

Where next for commissioning?

NHS Providers has published the next of its ‘Provider Voices’ series sharing a chief executive’s view on Where next for commissioning?

The chief executive of West Midlands Ambulance Service NHS Foundation Trust shares his view in relation to ambulance services.  Areas covered include designing pathways for continuous improvement, STPs, diversity of commissioning approaches and providing value for investment in commissioning.

Use of Resources assessment framework

A framework for evaluating how providers are making use of resources, leadership and governance in order to provide high quality care that is efficient and sustainable | NHS Improvement


Following sector-wide feedback, we’ve produced this framework, finalising our approach to the Use of Resources assessment. This will help us to better understand how effectively and efficiently providers are using their resources – including finances, workforce, estates and facilities, technology and procurement – to provide high quality, efficient and sustainable care for patients, and will help us to deliver tailored support to providers.

The Use of Resources assessment will also help us to identify providers’ support needs under the Single Oversight Framework (SOF), and deliver targeted support accordingly. We are now updating the SOF to reflect these and other changes in our oversight approach and will publish an updated version in October, following feedback.

Read the full overview here

The future of commissioning

NHS Providers has launched a new publication series “Provider Voices” which promotes the views of leaders from a range of trusts and other parts of the service on some of the key issues facing the NHS.


The first report Where next for commissioning? includes eight interviews that address concerns including the role of Sustainability and Transformation Partnerships (STPs) and accountable care systems (ACSs), the challenge of integrating health and care commissioning, and the future of the purchaser-provider split.



Clinical audit in commissioning

The Health care Quality Improvement Partnership has published Using Clinical audit in commissioning healthcare services.

This guide outlines how clinical audits can be used by commissioners to assure both quality and drive continuous improvement in patient care. It examines the strengths and limitations of clinical audit outputs for monitoring and assurance as well as considering how clinical audit can drive quality improvement as demonstrated through case studies and practical guidance.

Focus on general practice at the heart of local system change

Workforce development and collaboration are the twin themes of the latest issue of Commissioning Excellence, which highlights how local leaders are promoting the development of general practice at scale both to deliver the kinds of services communities demand and the resilience GP practices need.

This issue also focuses on the clinical pharmacists in general practice programme, which is bringing clear benefits to GPs and their patients.