Boost to joint commissioning is welcome
FPH welcomes the recognition that aspects of health services planning are not fit for purpose, as recently reported by the Health Service Journal (paywall). FPH's risk assessment summary of the Health and Social Care Bill raised the risk that Clinical Commissioning Groups (CCGs) would not be "adequately prepared/resourced/skilled to successfully commission both in terms of securing the best patient outcomes and value for money". It is not a fear we wanted to become reality.
We need CCG boundaries to match those of their local authorities: we cannot let commercial priorities override a common sense approach to service delivery, otherwise we will end up with dysfunctional relationships.
Commissioning support units (CSUs) have become like a shadow service whose position has not been defined by law. There are major risks to health planning by not having information and intelligence firmly in the system.
That's why CSUs should be brought back into the NHS. Quality needs to improve in primary care; the most important part of the health service. FPH believes NHS England is poorly placed to commission it, because it does not have the adequate resources to do so.
Commissioning should always be undertaken at appropriate levels for the size of the problem. That means rare conditions should be commissioned through national specialised services, specialised services at a regional level, hospital provisions at a more local level and primary care commissioning at the local level. Given that the Health and Social Care Act promotes competition over collaboration, the government's clamour for integration appears to need a legislative fix.
Written: 16/12/2013 , last modified: 05/03/2014