Commissioning and the coalition government

The Commissioning Academy is a Cabinet Office development programme for senior leaders from all parts of the public sector in which participants explore commissioning practices with a range of expert speakers, through case studies and discussion. It has developed some useful resources for anyone in public sector involved in commissioning including a Framework Document and other resources written by the Academy for Justice Commissioning including:


Table of contents

The Coalition Government and the NHS

The change of government in May 2010 brought radical change within the NHS with the “Equity & Excellence: Liberating the NHS ” white paper leading to the Health & Social Care Act 2012.

The Health & Social Care System after April 2013

The structure of the NHS – an outline of the organisational structure of the NHS and their functions.

A Short Guide to the Department of Health, A Short Guide summarising what the Department of Health and its arm’s-length bodies do, their costs, recent and planned developments, and what to look out for across the main business areas NAO July 2015

Understanding The New NHS – An updated guide (June 2014) from NHS England on the structure and function of the NHS, taking into account the changes of the Health and Social Care Act 2012.

A councillor’s guide to the health system in England, Local Government Association 15 May 2014. A useful guide for everyone, especially in times of increased integration.

The NHS reforms –  a reading list from the Kings Fund (udated May 2014)

Introduction to the NHS in England – official documents, commentaries, guides and web  resources. – a reading list from the Kings Fund (udated Feb 2014)

Explained: The new NHS structure from April 2013 – a prezi from Medeconomics (may not display on internet explorer, try Chrome or Firefx).

Health & Social Care Act 2012 Fact sheets from DH

Get in on the Act: The Health and Social Care Act 2012 – a guide to the legislation, which provides a summary of all the provisions of the Act and more details about the provisions of particular relevance to local government.

The health and care system from April 2013 – includes an interactive diagram which gives an overview of the new health and care system from April 2013. It illustrates the statutory bodies that make up the new system, oriented around people and communities and where they receive their local health and care services. Clicking on any of the organisations will provide you with more information about their specific role.

  • NHS Employers has produced A4 and A3 posters describing the new NHS
  • The presentation detailing the new structure and organisations can be viewed in New NHS Landscape by Liz Steel, NHS South England.
  • Consult the NHS reform Reading Room from the Kings Fund
  • Structure of the new NHS – An interactive diagram to show the structure of the new organisations and their responsibilities compiled by the BMA 
  • Watch the “Alternative guide to the new NHS in England” video from the Kings Fund
  • Regional Voices for Better Healthhas compiled a regional “Who’s Who” guide to support voluntary and community sector organisations make contact with people in the new health and care structures in each region, including clinical commissioning groups, health and wellbeing boards, local Healthwatch organisations, commissioning support units, CQC – in each local authority.

The Care Bill – (introduced 10 May 2013)

  • Legislation to provide protection and support to the people who need it most and to take forward elements of the government’s initial response to the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry led by Robert Francis (aka Francis Inquiry).
  • For more information see the Care Bill factsheets.

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The new organisations

See here for more about NHS organisations as described on the NHS Choices website.

See the HSJ interactive commissioning map (subscription required)  but note that this has not been updated.

NHS England
From April 2013, NHS England (previously NHS Commissioning Board April) took on many of the functions of PCTs with regard to the commissioning of primary care health services, as well as some nationally-based functions currently undertaken by the Department of Health.

NHS England is responsible for designing the proposed commissioning landscape and developing its business functions. This includes agreeing the method for establishing, authorising and running clinical commissioning groups (CCGs).  NHS England also commissions specialised services (including prison health and dental health and primary care). It also hosts clinical networks and clinical senates and NHS Improving Quality (NHS IQ). (see below)

Sections on the NHS England website include:

NHS Improving Quality (NHS IQ) “the driving force for improvement across the NHS in England”
NHS IQ draws on the experience of previous successful improvement programmes established by legacy organisations National Cancer Action Team and NHS Diabetes and Kidney Care.
NHS IQ also hosts:NHS Interim Management and Support (IMAS) and Improving Access to Psychological Therapies.

Academic Health Research Networks (AHRNs)
Part of the Innovation Health and Wealth strategy [Archived Content] to support cooperative working between the NHS, universities and industry.

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Health & Wellbeing Boards (HWBs)
HWBs bring together local commissioners across the NHS, public health and social care, elected representatives and representatives of HealthWatch to deliver integrated health and care services to improve the health and wellbeing of people in their area.

Health Education England (HEE)
National leadership organisation responsible for overseeing education, training, and workforce development. HEE is responsible for the local education and training boards (LETBs).The activities and functions of these bodies are described in the DH document Liberating the NHS: Developing the Healthcare Workforce From Design to Delivery (Jan 2012).

HealthWatch
Healthwatch England is the independent consumer champion for health and social care in England. Working with a network of 152 local Healthwatch organisations, it will ensure that the voices of consumers and those who use services reach the ears of the decision makers.

Monitor
Under the new NHS structure Monitor is to be the acute sector regulator for health adult social care. Monitor’s core duty would be to protect and promote patients’ interests.

National Quality Board (NQB)
NQB brings together the national organisations across the health system responsible for quality including the Care Quality Commission, Monitor, the NHS Trust Development Authority, NICE, the General Medical Council, the Nursing and Midwifery Council, the NHS Commissioning Board Authority and the Department of Health. Read the draft report on how the NQB will operate.

Public Health England (PHE)
Public Health England was established on 1 April 2013 to bring together public health specialists from more than 70 organisations into a single public health service. PHE works with national and local government, industry and the NHS to protect and improve the nation’s health and support healthier choices.

Details on the design of the new public health system including the role and responsibilities of local government in public health, the operating model for the new executive agency Public Health England and an overview of how the whole system will work. (Dec 2011). Includes:

  • The New Public Health System: Summary
  • Information on the transition via the Transforming Public Health Bulletin
  • Structure of Public Health England – Factsheet (Department of Health, 26 July 2012)
  • Vision for Public Health England  (Department of Health, 6 July 2012)
  • Public Health Outcomes Framework  (Department of Health  23 January 2012)
  • The New Public Health System: Summary, (Department of Health December 2011)

Health and Social Care Information Centre
The central repository of data and information relating to health and social care. From 1 April 2013 includes work previously carried out by Connecting for Health (site no longer  updated). 

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Key Resources

NHS reform – analysis and commentary from the Kings Fund

Department of Health Arms Length bodies (ALB) 2013/14 – a complete list (including NHS England), what they do and their business priorities.

gov.uk
The Department of Health website has been subsumed into the gov.uk website.There is a list of all UK government departments and agencies.

Authorities and Trusts
A list of all NHS trusts including Acute trusts,  Clinical commissioning groups, Mental Health trusts, Health & Care trusts, Ambulance trusts, Area teams, Special health authorities, on the NHS Choices website.

Modernisation of Health & Care
News, information and conversations from the Department of Health including Factsheets on key aspects of the legislation. This website is no longer updated (1 April 2013). See the gov.uk website for recent publications.

List of PCT functions drawn up to aid formation of GP consortia
The comprehensive list of statutory and non statutory functions drawn up jointly by the PCT Network (HSJ Article 30 Sept 2010). See also the Commissioning fact sheet – for clinical commissioning groups which sets sets out the services to be commissioned by CCGs. (DH, 26 July 2012)

Governance, regulation and accountability
A collection from the Kings Fund describing the implications of the White Paper “Equity and Excellence: Liberating the NHS”.

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