The NHS in England. A review for Q1 2024


A brief summary from our Head of Data looking at the current structural and commissioning landscape across the NHS in England in January 2024:


Increased formalisation of commissioning collaboration and delegation will continue in 2024 with more emphasis on funds being pooled and filtered down to a ‘place’ level.

The Government has indicated that it would like Local Partnerships to go further in terms of pooling local authority and NHS budgets. It has also helped facilitate increased collaboration and procurement options by the removal/relaxation of some of the existing competition and procurement rules which will give all parties of the NHS, and its partners, greater flexibility.

Integrated Care Boards (ICBs) are expected to delegate significant responsibilities, including commissioning and budgets, to place-based partnerships. Some ICBs are currently more advanced than others, formalising arrangements by the creation of place-based sub committees of the ICBs.

It is at a place level in Integrated Care Partnerships (ICPs) that brings the NHS (and its partners/collaborators) together with local authorities; at least one member of the ICBs is a local authority nominee. It would seem that some Integrated Care Systems (ICSs) are referring to ICPs as Health and Care Partnerships and the moniker of ICP is reserved for the formalised place-based sub committees of the ICBs.

There has been further movement on delegation by NHS England :

* ICBs already have responsibility for primary medical services (the responsibilities that were historically held by CCGs), but there will be/has been further delegation of primary care, pharmaceutical, general ophthalmic and dental (POD) services. 9 early ICB adopters tested the delegation and the deadline for all remaining ICBs was April 2023. To support this NHS regional teams are going to transfer staff working on POD commissioning to ICBs.

* Specialised commissioning; NHS England is responsible for 154 specialised services with an overall budget of around £23 billion. There is a proposed phased delegation of 65 of these services to ICSs (including, for example, major trauma, congenital heart disease, and radiotherapy). Current deadline for this is April 2024.

* There is the potential for further delegation of Section 7A public health functions (including, for example, cancer and non-cancer screening and immunisations) but much work left to do before this happens


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