Four commissioning functions expected to be carried out by clinical commissioning groups will now be performed by NHS Commissioning Board's regional bodies, the Department of Health has revealed.
DH guidance sent to PCT clusters states that “intelligence” such as collecting and organising data; “major clinical procurement”; back office functions such as IT, estates management, human resources and finance; and communications services are best done “at scale”.
The Towards Service Excellence document says the Department of Health considers the four functions “critical to the future smooth running of commissioning”, and that they risked becoming unsustainable if not centralised and that centralisation would also generate cost savings.
“There is evidence to indicate that initially a national approach might enable the most effective delivery of each of these services,” the guidance says.
A range of options for structuring these services are under consideration, including a single nationally managed service, delivered locally; a nationally-coordinated network, with teams in various locations providing different specialist elements, which could become separate organisations later; a hub, with the potential to create several organisations down the track; and a national specification and price with a range of approved suppliers.
The guidance seems to recommend that parts of NHS business intelligence are provided by strategic health authority-sized bodies. It says: “Evidence from South Central, West Midlands and East Midlands suggests aspects of business intelligence would be delivered most effectively by operations that cover an average population of around five million. If these sized units were replicated nationally this implies that these aspects of business intelligence could be provided from approximately 10 units.”
The document also recommends opening up commissioning support, which is currently provided by the NHS, to competition.