The Prescribed Specialised Services Advisory Group (PSSAG) has published its recommendations to Ministers laying out those services that NHS England may commission centrally going forward. The PSSAG is an expert committee within the Department of Health that provides advice on whether services are specialised and should be directly commissioned by NHS England, rather than by CCGs.
The recommendations are available here. As a comparison, the current nationally commissioned services are available here.
In deciding whether it would be appropriate for a service to be commissioned by NHS England rather than CCGs, the Secretary of State must have regard to four statutory factors (appearing in section 3B(3) of the National Health Service Act 2006, as amended by the Health and Social Care Act 2012). These are:
- the number of individuals who require the provision of the service or facility;
- the cost of providing the service or facility;
- the number of persons able to provide the service or facility; and
- the financial implications for Clinical Commissioning Groups if they were required to arrange for the provision of the service or facility
Before deciding to make regulations requiring NHS England to commission such services, the Secretary of State must (a) obtain appropriate advice for that purpose, and (b) consult NHS England. The Prescribed Specialised Services Advisory Group (PSSAG) was established by the Department of Health in 2013 to provide the Secretary of State with this advice. Therefore we appear to be at the first stage (a) above and a consultation will follow.
Given the ongoing work to provide detailed definition of NHS England commissioning, changes to the list of prescribed specialist services will be introduced in two stages:
- Commissioning responsibility for the three new services; hand transplantation, services for patients with atypical haemolytic uraemic syndrome (aHUS) and the Argus II retinal prosthesis system will sit with NHS England from April 2014. The changes to the terminology within the service descriptions for hyperbaric oxygen treatment and specialist cancer services will also be made from April 2014.
- The proposed transfers of commissioning responsibility for other services between Clinical Commissioning Groups and NHS England will be made on 1 April 2015.
The publication of the PSSAG report follows recent comments on commissioning by the new NHS Chief Executive, Simon Stevens, who said that he plans to give some CCGs the ability to co-commission primary care with NHS England. The services set out in the report will continue to be commissioned by NHS England, with the roll-out to co-commissioning pencilled in for 1 April 2015.