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Third phase implementation plan

Achievements and future priorities for developing world class commissioning.

Review of commissioning arrangements for specialised services: updated implementation project plan - January 2008

The first Implementation Plan for Sir David Carter’s Review of Commissioning Arrangements for Specialised Services in the NHS in England was published in November 2006, with a second phase version published in June 2007. This latest plan covers the next phase of changes, now that new structures have begun to bed down.

This updated plan demonstrates the progress made in the 18 months since the Carter Review was published and the steps taken to meet the longer-term challenges for the NHS. For planning purposes, the implementation remains divided into five workstreams.

Workstream One: Establishment of National Specialised Services Commissioning Group (NSCG) and National Commissioning Group (NCG)

Key achievements

  • The NSCG and NCG are well established and respected for their expert advice
  • Governance and supporting systems and teams are bedded down and working effectively and transparently
  • The NSCG has made important connections to the National Burns Care Group and the National Oversight Group for High Secure
  • Mental Health and established network fora for SCG Directors and SCG Heads of Finance
  • NSCG and NCG have agreed their work programmes and supporting budgets for 2008/9 through robust business planning processes
  • NCG recommendations for changes to the 2008/9 national commissioning portfolio have been supported by Ministers - a new NCG application process has been agreed for 2009/10

 What the NSCG will be leading in the next 12-18 months

  • Continue to promote the profile of specialised services commissioning and develop more effective commissioning arrangements for all specialised services across England

Workstream two: Re-organisation and strengthening of Specialised Commissioning Groups (SCGs)

What has been achieved

  • 10 new SCGs have been fully established with Directors in post and integrated commissioning teams
  • The new SCGs have established local governance arrangements that meet nationally agreed principles
  • All SCGs bar one collectively commissioned at least 10 specialised services in 2007/08 and all 10 SCGs are planning to extend their commissioning portfolios to cover the majority of specialised services in 2008/09

What the NSCG will be leading in the next 12-18 months

  • Continue to monitor progress and support SCG development through sharing of best practice and regular reporting to SHAs

Workstream three: Designation of specialised services providers

What has been achieved

  • NSCG has agreed with SCGs an initial programme of specialised services to be designated as a priority.


What the NSCG will be leading in the next 12-18 months

  • NSCG to produce supporting guidance and each SG to lead the work programme associated with designation of individual specialised services for a minimum of two specialised services each.

What more needs to be done

  • SCGs to continue a year-by-year programme for roll-out
  • Assess the impact of designation on quality and access on an ongoing basis.

Workstream four: Information

What has been achieved

  • Continued good progress on the review of an initial set of 8 definitions from the Specialised Services National Definitions Set
  • SCG members of the NSCG have agreed the resourcing of a 2008 work programme for the review of the remaining Definitions and creation of three new definitions
  • Websites have been established for the NSCG and the NCG with details of the 10 SCGs and the NCG’s commissioning arrangements and contact details.

What the NSCG will be leading in the next 12-18 months

  • Review and assess SCG progress in local strategies to strengthen Patient & Public Involvement
  • Agree a strategy on national clinical databases for specialised services and seek funding sources.

Workstream five: Co-ordinating DH system reform policy strands

What has been achieved

  • Raised the profile of specialised services within System Reform policy mechanisms
  • Key messages for NHS Implementation of the Carter Review have been highlighted in the 2008/9 NHS Operating Framework
  • DH has issued good practice guidance to the NHS about the commissioning of the national screening programmes
  • NSCG has agreed robust arrangements for the commissioning of High Secure Mental Health Services.

What the Department of Health  intend to do in the next 12-18 months, working with the NSCG

  • Ensure that that the development of Choice policy guidance for the planned 'Framework for Choice' reflects the key issues for specialised services
  • Ensure that the supporting tool kit for World Class Commissioning reflects good practice and excellence demonstrated by specialised service commissioners
  • Support the ongoing work of the Payment by Results team and ensure that the initial set of national developmental sites support the needs of specialised service commissioners.

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