Public involvement duty

 NHS England / CCGs must make arrangements to secure that individuals to whom services are being or may be provided are involved (whether by being consulted or provided with information or in other ways)-

  • In the planning of commissioning arrangements
  • In the development and consideration of proposals by the Board/CCGs for changes in the commissioning arrangements where the implementation of the proposals would have an impact on the manner in which the services are delivered to the individuals or the range of health services available to them, and
  • In decisions affecting the operation of the commissioning arrangements where the implementation of the decisions would (if made) have such an impact.

The changes taking place in Greater Manchester in April 2016 relate to (a) above ie the planning of commissioning arrangements. This document is intended to provide information about the changes.

 Explanation of the changes

 Some services are currently commissioned directly by NHS England on behalf of the population of England rather than by local organisations in each community. These include some public health services such as the national immunisation programmes (n=17), national screening programmes (cancer and non cancer- n= 12) and child health information services, along with approximately 200 ‘specialised services’. These specialised services cover a broad range: from relatively common services which many people in a region use and which several local organisations provide, such as chemotherapy and renal dialysis, to very specialised services which are only provided in one or two places in the country, , as so few people require them.

We are planning to change the commissioning arrangements for some of the services that NHS England directly commission, including some public health services and some of the specialised services currently commissioned through NHS England’s North West Specialised Services team.  Those specialised services affected are those that are delivered by organisations within Greater Manchester exclusively, or predominantly, for the local population within Greater Manchester.

From 1 April 2016, these services will continue to be commissioned by NHS England, but decisions about service changes, finances, and quality and performance will be made through the Chief Officer of Greater Manchester Health and Social Care.

Specialised services commissioned for the Greater Manchester population through these new arrangements will continue, as a minimum, to meet national service specifications and national policies developed by NHS England, however the standards described in these may be augmented or expanded on in response to the local needs of the population in Greater Manchester.

The contract negotiation, monitoring of performance and quality and minor service model changes would continue to be undertaken by the teams that do this now, but in liaison with the Chief Clinical Officer and Chief Operating Officer of NHS Trafford CCG. NHS Trafford CCG has worked closely with NHS England’s North West Specialised Commissioning hub, and co-ordinated conversations with the Specialised Commissioning team on behalf of all 12 Greater Manchester CCGs, over a considerable period of time. These arrangements were agreed at the first shadow Greater Manchester Joint Commissioning Board in January 2016.

This is part of the wider devolution programme in Greater Manchester, which is giving Greater Manchester control over the £6 billion health and social care budget spent there.

We are also planning some changes to commissioning arrangements for GP services.  As part of NHS England’s national policy initiative to enable CCGs to take an increased role in the commissioning of GP services in their area, two CCGs in Greater Manchester (Oldham and Wigan) have already assumed full responsibility for commissioning GP services.  From 1 April 2016 the remaining ten CCGs in Greater Manchester are also expected to assume full responsibility for commissioning GP services in their respective areas. CCGs are engaging with their local populations about these changes and queries or comments should be directed to them.

How will this affect patients in Greater Manchester and patients outside Greater Manchester?

There will be no immediate impact on patients.  All services that are currently commissioned will continue to be commissioned, and the manner in which those services are delivered will not change.

However, as we plan for the future, we will be planning to increasingly take commissioning decisions about those public health and specialised services which are largely delivered here to people from here, specifically with the those people of Greater Manchester in mind, using the powers contained in the Cities and Local Government Devolution Bill. However we will of course continue to work closely with colleagues in the rest of the North West and nationally, to make sure that proposals properly account for patients who live outside Greater Manchester, but travel in for services.  CCGs will be making their own clear and joined up plans for primary care, aligned to wider plans to improve health services across Greater Manchester.  These plans may lead to changes in the way in which those services are delivered, for the benefit of Greater Manchester.  We will involve patients in any proposal that may result in changes to the way in which services are delivered.

How will this affect service providers in Greater Manchester?

Service providers currently have one contract with NHS England for all the specialised services they provide, whether those services are largely to GM people or to people from the north west, or even nationally. This will not change in the coming financial year, however it will be considered as part of the moves to commission some public health and specialised services specifically with the people of Greater Manchester in mind.

NHS England will continue to directly commission the Specialised Services outside of these new arrangements in the same way that they do now, and will continue to commission the services within the scope of these arrangements from providers within Greater Manchester for patients that come from areas outside of GM in the way that they do now.

How can I be involved?

 If you would like to comment on these proposals and/or be involved in discussions about future changes to commissioning arrangements, please email titling your email ‘commissioning arrangements’. Your comments will be shared with NHS England as well.

Which services are we changing the arrangements for?

  • Cardiac Surgery (Adult)
  • Cardiology: Magnetic Resonance Imaging (Adult)
  • Cardiology: Electrophysiology & Ablation Services (Adult)
  • Cardiology: Primary Percutaneous Coronary Intervention (Adult)
  • Specialised Vascular Services (Adult)
  • Colorectal: Complex Inflammatory Bowel Disease (Adult)
  • Colorectal: Faecal Incontinence (Adult)
  • Colorectal: Transanal Endoscopic Microsurgery (Adult)
  • Acute Kidney Injury (Adult)
  • Assessment for Renal Dialysis (Adult)
  • Renal Dialysis (Hospital) (Adult)
  • Renal Dialysis (Home) (Adult)
  • Renal Dialysis (Peritoneal) (Adult)
  • Neurosurgery (Adult)
  • Neurosciences (Adult)
  • Specialised Rehabilitation for Complex Needs (Adult)
  • Specialised Orthopaedics (Adult)
  • Specialised Ophthalmology (Adult)
  • Specialised Ophthalmology (Paediatric)
  • Complex Spinal Surgery
  • Major Trauma
  • Implantable Hearing Aids for Microtia
  • Bone Anchored Hearing Aids
  • HIV Treatment services (Adult)
  • Haemoglobinopathies
  • Specialised Immunology (Adult)
  • Specialised Allergy (Adult)
  • Oesophageal and Gastric Cancer (Adult)
  • Kidney, Bladder and Prostate Cancer (Adult)
  • Head and Neck Cancer (Adult)
  • Chemotherapy (Adult)
  • PET-CT
  • Paediatric Rheumatology
  • Paediatric Endocrinology & Diabetes
  • Paediatric Respiratory Medicine
  • Paediatric Allergy
  • Complex Gynaecology: Urogenital and Anorectal conditions
  • Complex Gynaecology: Recurrent Prolapse and Urinary Incontinence
  • Gynaecological Cancers (Adult)
  • National immunisation programmes (n=17)
  • National screening programmes (cancer and non-cancer- n= 12)
  • Child Health Information Services, including child health records departments and IT systems