News

What is the NHS Future Forum?

The NHS Future Forum was brought together to gather views and advise on any changes to the health and Social Care Bill. This approach has caused a ‘pause’ in the progression of the radical reforms. The Forum has now reported on its findings in the following areas:

• Choice and competition
• Clinical advice and leadership
• Education and training
• Patient involvement and public accountability

There is also a summary report available here.

Recommendation: Consortia

• Should only be allowed to take responsibilities of commissioning when readiness can be demonstrated. Assessment of skills, competencies and capability should be central to the consortium authorisation process. Where a consortium is shown not to be ready, The NHS Commissioning Board should commission on their behalf and support the consortium to become ready. The deadline of April 2013 for all consortia to go live should be relaxed.
• Should have a Governing Body that meets in public and has effective independent representation to protect against conflicts of interest

Response from Government

• The term GP Commissioning Consortium will be dropped and the newly formed Clinical Commissioning Groups [CCG] must use the NHS brand and incorporate the name of the local area they represent in their name.
• All CCGs will be required to involve patients, the public and carers in their decision making.
• A CCG must have at least one registered nurse and at least one hospital doctor specialist on the board, both of which are not employed by a local provider .
• A CCG must also have 2 independent representatives: one role to cover PPI and the other to oversee governance, audit, remuneration and any conflicts of interest. One of these lay representatives should assume the role of Chair or Vice Chair.
• Boundaries will not be allowed to cross that of the local authority unless there is a justifiable rationale
  The CCG must have a Governing Body that will sign up to the Nolan principles, meet in public and publish minutes and reports.
• All CCGs will have a duty to promote integrated services for patients supported by evidence and information.
• All CCGs shall be ‘statutory bodies’ by 2013 either as an authorised group or in shadow form. Whilst in shadow form the NHS Commissioning Board will commission on their behalf.
• Health and Wellbeing Boards will be formally involved in the CCG authorisation process.

Recommendation: Clinical Senates

• In order to be assured that a range of health and care professionals are involved in the design of services all CCGs [formally consortia] should be required to seek multidisciplinary advice to inform both the commissioning and authorisation process. Any ongoing annual assessments for the CCG should include an assurance test of this. Clinical Senates should be established to support the process and to provide advice to Health and Well Being Boards and the NHS Commissioning Board.

Response from Government:

• Clinical Senates to be established as a function of the NHS Commissioning Board and will advise the NHSCB on clinical commissioning models, so they will also assume a role in the authorisation process.
• There will be multidisciplinary representation on a Clinical Senate which will include Public Health and it is anticipated that CCGs will be expected to also seek advice from this new clinical structure.
• NHSCB intend also to maintain networks.

Recommendation: NHS Commissioning Board

• Should be established as soon as possible

Response from Government:

• Will be established by October 2012 and will reflect multidisciplinary approach in terms of having a Chief Nursing officer and a Medical Director on the Board.
• PCTs will be abolished in April 2013 and arrangements will be developed to establish the role of PCT clusters before the abolition of PCTs. The arrangements for PCT clusters will be reflected in local arrangements of the NHS Commissioning Board.
• In this context SHAs will remain as statutory bodies until April 2013 but will from SHA clusters during 2011 

Recommendation: Choice and Competition

• NHS Commissioning Board should have a 'choice mandate' setting the parameters for choice and competition.
• HealthWatch England should report [via a Citizens Panel] to Parliament on the implementation of the mandate and its progress.
• Monitors role should be diluted with a requirement to support choice, collaboration and integration.
• Safeguards should be introduced to prevent private providers from 'cherry picking'

Response from Government:

• NHSCB will have a 'choice mandate' and commissioners will have a duty to promote choice.
• Patient choice will also be extended via the introduction of 'Any Qualified Provider'. The process for this will start in April 2012.
• Instead of having a duty to 'promote competition', Monitor will have a duty to 'protect and promote' patients interests.
• Safeguards will be introduced to prevent 'cherry picking'.

Recommendation: Health and Well Being Boards

• The role should be strengthened giving these Boards power to require the commissioners of services to account for their commissioning strategies if they do not align with the strategy of the local Health and Well Being Board.

Response from Government:

• Will have a duty to involve users.
• Will have a formal role but no power of veto in the CCG authorisation process.
• Shall  promote joint commissioning

Recommendation: NHS Constitution

• A duty to be placed on the NHS Commissioning Board and Clinical Commissioning Groups [formerly consortia] to promote the NHS Constitution.
• Monitor, CQC, NHSCB and CCGs should be required to describe how they do this in their annual plans

Response from Government:

• A duty will be placed on the NHSCB and CCGs as requested.
• Annual reports will be required to demonstrate how this is achieved.