The role of the NHS Commissioning Board

The NHS Commissioning Board will be nationally accountable for the outcomes achieved by the NHS, and provide leadership for the new commissioning system.


The White Paper ‘Equity and Excellence: Liberating the NHS’ (July 2010) set out the Government’s vision for health services. It describes a new commissioning architecture for the NHS as one of the key drivers through which real improvements for patients will be made, in conjunction with an increasingly liberated provider market and the new public health service.

Responsibility for local commissioning will rest with GP consortia, supported and overseen by the NHS Commissioning Board, which will hold consortia to account for the quality of outcomes they achieve.  The new architecture will take on many of the roles and responsibilities currently discharged by the Department of Health, Strategic Health Authorities and Primary Care Trusts.

The Health and Social Care Bill 2010-2011, which takes the White Paper forward, was presented to Parliament on 19 January 2011 and is currently taking written evidence before moving into its report stage.

Role of the NHS Commissioning Board

Nationally accountable for the outcomes achieved by the NHS, the NHS Commissioning Board will provide leadership for the new commissioning system. It will provide the support and direction necessary to improve quality and patient outcomes and safeguard the core values of the NHS.

The NHS Commissioning Board has overall responsibility for a budget of £80bn, of which it will allocate £60bn directly to GP consortia.  It will directly commission a range of services including primary care and specialised services and have a key role in improving broader public health outcomes.

The Board’s central role is to drive improvement in outcomes for patients, ensuring a fair and comprehensive service across the country.  It will also promote the NHS Constitution and champion the interests of patients, using choice and information to empower people to improve services.

Accountable to the Secretary of State via an annual mandate, the NHS Commissioning Board will be an independent, statutory body, free to determine its own organisational shape, structure and ways of working.

Responsibilities of the NHS Commissioning Board

  • Supporting continuous improvements in the quality and outcomes of NHS-funded services
  • Promoting and extending public and patient  involvement and choice
  • Ensuring a comprehensive system of GP consortia, supporting them and holding them to account, including working in partnership with local government and other organisations
  • Directly commissioning certain services
  • Allocating and accounting for NHS resources
  • Promoting equality and reducing inequalities in access to healthcare, in co-operation with Public Health England.

Leadership and location of the NHS Commissioning Board

In January 2011, Sir David Nicholson, was confirmed as Chief Executive designate of the NHS Commissioning Board. The recruitment of the Chair is underway, and the senior team structure will be published in due course.

Based at Quarry House, in Leeds, the NHS Commissioning Board will also have a small base at Maple Street, in London.

Implementation of the NHS Commissioning Board

Initially, the NHS CB will be established as a Special Health Authority (SpHA) and undergo a period of shadow running, before becoming fully operational as a non departmental public body.

A transitional team of NHS and DH staff has been set up, under the leadership of Tim Rideout, to support the establishment of the Special Health Authority and non departmental public body. The team’s remit includes making recommendations on the NHS Commissioning Board’s functions to the substantive management team of the Special Health Authority and managing the transition from the current system.  In its shadow period, the three key functions for the NHS Commissioning Board are to:

  • Develop the capability and capacity to ensure that can discharge its duties
  • Oversee the development of GP consortia and the associated architecture including authorisation, assurance and intervention.
  • Future planning  including quality improvement, public and patient involvement and choice, contact negotiation, price setting with Monitor.

To meet these objectives, the NHS Commissioning Board implementation programme has organised itself into four broad areas of work:

  • Developing proposals for the functions of the NHS Commissioning Board, including how it will discharge its responsibilities
  • Establishing the new organisation, including accommodation and governance
  • Transition, including ensuring stability and continued delivery
  • Supporting work, including programme and relationship management.
In Commissioning

2 Responses to The role of the NHS Commissioning Board

  1. A substantial problem with the way commissioning plans appear at present is that they are fine for supraregional specialties, and at local level for the services a district hospital normally provides. However they do not seem to provide a way for effective strategic decisions to be taken city wide, or connurbation wide, as in London or Birmingham. London, in particular, has a long history of needing and benefiting from cross border consideration. The most recent example of an attempt, paediatric cardiac surgery, has been shown to be open to bias, special pleading and the ignoring of patient outcomes. However in Trauma, heart attacks and strokes the results have been fantastically worthwhile.
    We must be able to do better so please try harder.
    Geoffrey Rivett

  2. Penny Ann Budgen says:

    Gosh. Nothing commented on for over a year.

    One question: How can a service user influence change and improve patient experience and outcomes in the NHS? Via the Commissioning Board?