Agenda item

Debra Elliott (NHS England) will provide an update on the development of the 5 Year Strategy for Specialised Services noting that it is expected to be published in draft form in the next few months.

Debra Elliott, NHS England, presented the report on the NHS England five year commissioning plan for specialised services. 

In presenting the report confirmation was given that the strategy was being developed following a period of significant change in the structures of specialised commissioning arrangements, noting that from April 2013 NHS England became the sole direct commissioner of specialised services. 

The report highlighted that the cost of NHS specialised health services was approximately £12 billion per year which equated to approximately 10% of the total annual NHS budget and detailed where NHS England was in relation to the development of the plan and consultation undertaken.  This included a well attended event held in Chippenham on 13 February as well as engagement with Overview and Scrutiny Committees (OSCs) and Clinical Commissioning Groups (CCGs).

The development of the strategy was to be separated into two parts:

·         A mission statement (detailing the director of travel for the strategy for 2014/15-2018/19; and

·         Service level planning (detailing priorities for individual services).

The new interim Chief Executive of NHS England, Simon Stevens, was likely to have a specific view on specialised commissioning and was expected to want to review any work undertaken before release in June 2014.

Concerns were expressed over the potential evolution of specialised services away from Wiltshire, noting that many services were already outside of the county.  The Board were also mindful of some transport issues to and from some specialised centres and the potential impact this had on the health and wellbeing of patients and were of the view that the development of a hub and spoke model would be desirable.

It was understood that concerns had also been raised by the Wiltshire Overview and Scrutiny Committee (OSC) and Public Health.  Discussions had taken place with the Director of Public Health England and also with the Director of Specialised Services. The Board were informed that further local discussion (including with OSCs and CCGs) was to take place to ensure there was a clear understanding of the national programme and to allow for any concerns to be discussed.

The question of how outcomes would be monitored for the new system against those of the old was raised.  Although there was confidence that good outcomes would be delivered there was still concern relating to the services that could be catered for within the existing acute hospitals and how they would continue to serve the local population.

Noting that further discussion were to take place, commissioning plans for specialised services would remain as an item for discussion at a future meeting of the Board.

The Chairman of the Health Select Committee, in attendance, confirmed that these concerns were indeed shared by the OSC and welcomed the opportunity to work with the Board in providing a joint response to NHS England on the subject.  An important immediate priority was vascular services.

The Chairman reminded the Board that a significant number of armed forces personnel were due to rebase to the UK from Germany and there would be the need to ensure any required health services were available to support their needs upon return.

It was understood that funding had been ring fenced for the rebasing of personnel and that this included funding to local authorities to ensure health and educational needs were appropriately met.  Discussion took place on whether the funding to be allocated would meet the need.

Debra Elliott noted the concerns raised by the Board and would ensure that these were relayed to the appropriate officers at NHS England.

The Chairman thanked all for the comments received and it was agreed that a letter from the Board on behalf of all partners would be sent to NHS England expressing the concerns raised.

Resolved:

The Board

·         Noted the update provided;

·         Agreed to receive a further update from NHS England on progress made in producing the Strategy; and

·         Agreed that a response to the emerging strategy would be sent by the Chairman on behalf of all partners of the Board to NHS England expressing the concerns raised.