|non-departmental public body overview|
|Formed||1 April 2013|
|non-departmental public body executives|
|Parent department||Department of Health|
NHS England oversees the budget, planning, delivery and day-to-day operation of the commissioning side of the NHS in England as set out in the Health and Social Care Act 2012. It holds the contracts for GPs and NHS dentists.
NHS England is the operating name of the NHS Commissioning Board and, before that, the NHS Commissioning Board Authority. It was set up as a special health authority of the NHS in October 2011 as the forerunner to becoming an NDPB on 1 April 2013. It was renamed NHS England on 26 March 2013. Its legal name remains the NHS Commissioning Board.
Sir David Nicholson who became Chief Executive at the establishment of the Board retired at the end of March 2014 and was replaced by Simon Stevens. One of Stevens' first acts was to announce a restructure of its 27 area teams in response to a requirement to reduce running costs which would reduce staffing by around 500. The 27 teams outside London are to be reduced to 12 in 2015.
NHS England in conjunction with the other central regulators established what is called a "success regime" in south and mid Essex, North Cumbria and north east and western Devon in June 2015. It is intended to tackle “deep rooted and systemic issues that previous interventions have not tackled across [a] whole health and care economy”.
In 2016 it organised the geographical division of England into 44 Sustainability and transformation plan areas with populations between 300,000 and 3 million. These areas were locally agreed between NHS Trusts, local authorities and Clinical Commissioning Groups. A leader was appointed for each area, who is to be responsible for the implementation of the plans which are to be agreed by the component organisations. They will be "working across organisational boundaries to help build a consensus for transformation and the practical steps to deliver it".
Applications by GPs to reduce their catchment area are dealt with by NHS England. Requests to reduce the number of patients eligible to join a practice and in some cases also to deregister existing patients, have risen with 26 made between April and October 2014 compared to 30 for the whole of 2013/14. Only 15 have been approved.
In November 2014 Mr Justice Popplewell declared that NHS England “has acted unlawfully by reason of its failure to make arrangements for the involvement of patients in primary care commissioning decisions as required by the National Health Service Act 2006”. The case involved the decision to scrap minimum practice income guarantee. Richard Stein, a partner at Leigh Day, said the declaration could mean that patients would have to be involved in discussions on changes to the GP contract.
NHS England awarded a 4-year contract to Capita to become sole provider of administrative services including payment administration, management of medical records, and eligibility lists for practitioners for GPs, opticians and dentists across the UK in June 2015.
See also General medical services
The organisation was reported to be developing a strategy to support the use of personal health records in June 2015. This, it is hoped, could achieve up to £3.4 billion in annual efficiency savings by 2020. In April 2016 it published an index of digital maturity, where each of the 239 NHS trusts assessed its own "readiness", "capabilities" and "Enabling infrastructure".
Specialised services are those provided in relatively few hospitals, accessed by comparatively small numbers of patients but with catchment populations of usually more than one million. These services tend to be located in specialised hospital trusts that can recruit a team of staff with the appropriate expertise and enable them to develop their skills.
NHS England is responsible for commissioning £15.6 billion of specialised services to meet a wide range of health and care needs. These include a range of services from renal dialysis and secure inpatient mental health services, through to treatments for rare cancers and life threatening genetic disorders. The commissioning of specialised services is a prescribed direct commissioning responsibility of NHS England.
Four factors determine whether NHS England commissions a service as a prescribed specialised service. These are:
- The number of individuals who require the service;
- The cost of providing the service or facility;
- The number of people able to provide the service or facility and
- The financial implications for Clinical Commissioning Groups (CCGs) if they were required to arrange for provision of the service or facility themselves.
The ambition of NHS England is to bring equity and excellence to the provision of specialised care and treatment. This is achieved through a commissioning process which:
- is aligned with the priorities of NHS England as set out within the NHS Mandate and the strategic way forward within the Five Year Forward View;
- is patient-centred and outcome based. The patient must be placed at the centre of planning and delivery. Commissioners, working with providers, must deliver improved outcomes for them across each of the five domains of the 2013/14 NHS Outcomes Framework;
- is fair and consistent throughout the country, ensuring that patients have equal access to services regardless of their location, and;
- Improves value, productivity and efficiency.
The Specialised Commissioning directorate of NHS England takes a consistent approach to central planning of specialised services which is delivered locally. It works to raise the standards of care for all patients receiving treatment for rare and specialised conditions, ensuring that patients have equal access to services regardless of their location.
Funding of Clinical Commissioning Groups
NHS England allocates funding (of £69.5 billion in 2016/7) to CCGs in accordance with a funding formula. Until 2016 progress towards the amount indicated by the formula from the historical allocation was very slow, and CCGs which were above their allocation did not actually suffer a reduction. From April 2016 however CCGs with more than 10% above their fair share will receive "flat cash" - an effective reduction. This will also ensure than no CCG is more than 5% below its target allocation in 2016/7.
- "About us". NHS Commissioning Board. Retrieved 12 Feb 2013.
- "About us". NHS England. Retrieved 11 April 2013.
- "About us". NHS Commissioning Board Authority. Retrieved 30 May 2012.
- "NHS England Chairman welcomes new name". NHS England. Retrieved 11 April 2012.
- "Exclusive: NHS England to cut hundreds of posts in restructure". Health Service Journal. 29 July 2014. Retrieved 18 September 2014.
- "Revealed: NHS England's new area team structure". Health Service Journal. 1 October 2015. Retrieved 24 October 2014.
- "Mackey: Success regime not working fast enough". Health Service Journal. 29 January 2016. Retrieved 11 March 2016.
- "The leaders chosen for 41 of England's STPs". Health Service Journal. 30 March 2016. Retrieved 8 April 2016.
- "NHS England rejects one in four requests to shrink GP catchment areas". Pulse. 27 October 2014. Retrieved 2 November 2014.
- "NHS England primary care decisions 'unlawful', High Court rules". Health Service Journal. 24 November 2014. Retrieved 15 December 2014.
- "Capita is awarded NHS England admin contract worth up to £1bn". City AM. 23 June 2015. Retrieved 26 June 2015.
- "NHS developing PHR adoption strategy". Digital Health. 9 July 2015. Retrieved 11 July 2015.
- "Digital Maturity Assessment". NHS England. Retrieved 1 November 2016.
- "First digital maturity index scores in full". Health Service Journal. 12 April 2016. Retrieved 19 June 2016.
- "Mapped: Quarter of area teams resort to NHS England arbitration". Health Service Journal. 19 March 2015. Retrieved 1 May 2015.
- "Major allocations shakeup means real terms cuts for some CCGs". Health Service Journal. 17 December 2015. Retrieved 28 February 2016.