What is specialised commissioning?
In this article, we will describe what is specialised commissioning.
Certain conditions require a different form of commissioning (buying) healthcare. They are generally rare conditions with these features:
- They are expensive
- The infrastructure required to deliver the services requires planning on a geographical scale bigger than a local commissioner – i.e. ICS
- The clinical teams that provide the care are very specialised; hence services are centralised into a few hospitals (usually the teaching hospitals).
In England, it is conducted at a national (and regional) level by NHS England who determine policy and strategy objectives, manage existing specialised services; and manage the process to consider future specialised services for commissioning.
There are seven regional Specialised Commissioning teams (one per NHSE Region). They deliver the strategy developed by the national team, and secure services in line with national standards. The Regions have contracts for specialised services from providers (mainly hospitals); and for this, they use what is called the ‘NHS Standard Contract’.
NHSE Regional teams also provide operational support for the delivery of these services.
Pros and cons of specialised commissioning
Such services are not cheap. The budget for them in 2020/21 was £20.5 billion (c. 17% of the NHS budget in England). But in 2022/23 the planned spend for specialised services is £22.9 billion, i.e. costs are increasing.
The argument for this concept is that it protects the care for expensive and rare diseases. The argument against the concept is that this detracts from people with more common diseases, who are looked after by GP, mental health services and local smaller hospitals.
Future of specialised commissioning
As Integrated Care Systems (ICSs) start functioning, it is unclear how specialised commissioning will occur in the future.
Summary
We have described what is specialised commissioning. We hope it has been helpful.
