Specialised Services Identification Rules Handbook

Specialised Services Identification Rules Handbook
NHS England 24 October 2017

• Guidance to health care providers and commissioner organisations to ensure identification of specialised/prescribed healthcare activities.
• The Identification Rule Handbook outlines how Specialised Service activity can be identified using data flows collected by healthcare trusts and compliments the PSS 2017/19 Identification Rules software tool produced by NHS Digital.

Spotlight on specialised services

Spotlight on specialised services
NHS England 12 September 2017

• Specialised services funded by NHS England are grouped into six National Programmes of Care: blood and infection; cancer; mental health; internal medicine; trauma; and women and children. This pamphlet highlights examples of recent investments across these areas.

NHS England Board meeting 26 May 2016

NHS England Board meeting, 26 May 2016
Highlights by Anne Gray, Knowledge Officer, Arden & GEM CSU

Papers available here.  Video available here. Minutes available here.

Agenda
Item 1: Board meeting agenda
Item 2: Minutes of meeting held on 31 March 2016
Item 3: Chief Executive’s Report
Item 4: Sustainability and Transformation Plans – progress report
Item 5: Strategic Framework
Item 6: NHS England Corporate and NHS Performance report
Item 7: NHS England Finance Report
Item 8: NHS England Governance Manual Approval
Item 9: NHS England Complaints Policy Update
Item 10:Conflicts of Interest summary report
Item 11: Update on NHS Diabetes Prevention programme
Item 12 Healthy Workforce
Item 13a Audit and Risk assurance Committee - verbal
Item 13b Commissioning Committee Update
Item 13c Specialised Services Commissioning Committee Update
Item 13d Investment Committee Update

Strategic Framework for Specialised Services

Forward View for Specialised Services: Strategic Framework
NHS England Board Meeting, 26 May 2016

• This paper was presented to the NHS England Board meeting on 26 May 2016.
• It outlines the vision and key elements of a new strategic framework for specialised services in 2020 and the next steps in achieving ambitions for specialised services, including local collaboration and national level support.
• More detail on implementation and commissioning intentions will be published in the autumn.
• The strategic framework sets out eight priorities which cover three issues: delivering place- and population-based care, providing national level support and ensuring financial sustainability and value for money.
• This vision and approach signal a fundamentally new direction for specialised services over the next five years on a number of elements in particular
• Recognition that different service models will be required to meet national standards:
• Moving away from a ‘binary choice’ of national or local commissioning:
• Moving towards a plurality of provider models:
• Using the leadership and expertise of clinical reference groups to transform future patient outcomes:
• Moving from ‘transactional’ use of information to rewarding high quality care
• Step change in the adoption of new treatments.

Manual for prescribed specialised services 2016/17

Manual for prescribed specialised services 2016/17
NHS England 1 May 2016

• A revised version of the manual for prescribed specialised services, the technical document that sets out what NHS England and what CCGs commission in respect of specialised services. 
• The document has been updated to reflect services where commissioning responsibility has transferred from NHS England to CCGs and vice versa.
• One of the key documents for Specialised Services.

Commissioning Intentions 2016/2017 for Prescribed Specialised Services

Improving Value for Patients from Specialised Care; Commissioning Intentions 2016/2017 for
Prescribed Specialised Services
NHS England 30 September 2015

• Agreed changes to the Scope of Specialised Services:
• Adult specialised severe and complex obesity services should no longer be commissioned by NHS England and should be reflected in CCG contracts from April 2016. 
• Some highly specialist adult male urological procedures; Primary ciliary dyskinesia management services for adults and some highly specialist adult haematology services will no longer be commissioned by CCGs 
• NHS England intend to strengthen the way they commission by building on the 10 cocommissioning oversight groups established across England, and will tier the specialised service portfolio to enable further collaborative commissioning engagement of CCGs around key geographies and place-based planning, whilst ensuring consistent national standards apply. 
• The single operating model will be applied to all contracts in 2016/17.

Commissioning intentions for prescribed specialised services

Commissioning Intentions 2015/16 for Prescribed Specialised Services
NHS England, 3 October 2014

• This document serves as notice to all providers of specialised services in England of changes and priorities for the coming year for the specialised services to be commissioned by NHS England. 
• Commissioning responsibility for the following services will move to CCGs as from April 2015:
• specialised wheelchair services
• outpatient neurology referrals made by GPs to Adult Neurosciences Centres
• outpatient neurology referrals made by GPs to Adult Neurology Centres 
• It has been recommended that responsibility for commissioning these services will be moved to CCGs by April 2015
• renal dialysis (excluding encapsulating sclerosing peritonitis surgery)
• surgery for morbid obesity
• The following services will no longer be commissioned by CCGs from April 2015:
• some highly specialised adult male urological procedures
• some adult oesophageal procedures
• services for patients with homozygous familial hypercholesterolaemia
• some adult specialist haematology services
• Adoption of the information rules (IR) toolkit will be mandatory in 2015/16 and will require liaison between providers, NHS England and CCGs to jointly manage the alignment of contracts, activity flows and commissioning budgets.
• NHS England will be establishing arrangements to co-commission the majority of specialised services in partnership with CCGs
• Clinical thresholds and unwarranted variation in access to care - A programme will be developed to review differences in population intervention rates relative to need, involving provider clinical teams, NHS England and CCG commissioners, supported by Public Health England, to understand and resolve the addressable causes of outlying practice. 
• Clinical utilisation review (CUR) - NHS England has introduced a CQUIN to support providers in adopting the technology for specialised admitted patient care and critical care in 2014/15. The CUR CQUIN scheme is being made for use by CCG commissioners where it fits with local priorities such as underpinning changes to meet the goals of the Better Care Fund and improved Urgent & Emergency care.

What CCGs do not commission

Prescribed Specialised Services Advisory Group: Recommendations to Ministers
PSSAG Secretariat, Department of Health, 2 May 2014

• The PSSAG advises ministers on when NHS England should commission specialised services, rather than Clinical Commissioning Groups (CCGs).

Non-specilaised service interim policies

Interim commissioning policies for non-specialised services
NHS England, 19 November 2013

• NHS England has published 37 nationally consistent commissioning policies many of which were previously local low priority policies.
• These are interim policies and will be subject to full public consultation during 2014.

Specialised commissisioning Clinical Leadership Groups

National programmes of care and clinical reference groups (CRGs)
NHS England, May 20133

• The direct specialised commissioning function of NHS England is supported by a devolved clinical leadership model. CRGs covering all prescribed specialised services. They are responsible for preparing national specialised service strategy and developing specialised service contract products such as specifications and policies.
• The five national Programmes of Care (PoC), which bring together services in functional groupings are 
• Internal Medicine
• Cancer & Blood
• Mental Health
• Trauma
• Women & Children