NHS England

This article is about the oversight body. For the health service in England, see National Health Service (England).

NHS England

non-departmental public body overview
Formed	1 April 2013
Jurisdiction	England
Headquarters	Leeds
non-departmental public body executives	Professor Sir Malcolm Grant CBE, Chairman Simon Stevens, Chief Executive
Parent department	Department of Health
Website	www.england.nhs.uk

NHS England is an executive non-departmental public body (NDPB) of the Department of Health.

NHS England oversees the budget, planning, delivery and day-to-day operation of the commissioning side of the NHS in England as set out in the Health and Social Care Act 2012. It holds the contracts for GPs and NHS dentists.

NHS England comprises around 6,500 staff in 50 sites around England. The bulk of its staff previously worked for the decommissioned primary care trusts and strategic health authorities.

History

NHS England is the operating name of the NHS Commissioning Board and, before that, the NHS Commissioning Board Authority. It was set up as a special health authority of the NHS in October 2011 as the forerunner to becoming an NDPB on 1 April 2013. It was renamed NHS England on 26 March 2013. Its legal name remains the NHS Commissioning Board.

Sir David Nicholson who became Chief Executive at the establishment of the Board retired at the end of March 2014 and was replaced by Simon Stevens. One of Stevens' first acts was to announce a restructure of its 27 area teams in response to a requirement to reduce running costs which would reduce staffing by around 500. The 27 teams outside London are to be reduced to 12 in 2015.

System management

NHS England in conjunction with the other central regulators established what is called a "success regime" in south and mid Essex, North Cumbria and north east and western Devon in June 2015. It is intended to tackle “deep rooted and systemic issues that previous interventions have not tackled across [a] whole health and care economy”.

In 2016 it organised the geographical division of England into 44 Sustainability and transformation plan areas with populations between 300,000 and 3 million. These areas were locally agreed between NHS Trusts, local authorities and Clinical Commissioning Groups. A leader was appointed for each area, who is to be responsible for the implementation of the plans which are to be agreed by the component organisations. They will be "working across organisational boundaries to help build a consensus for transformation and the practical steps to deliver it".

Primary care

Applications by GPs to reduce their catchment area are dealt with by NHS England. Requests to reduce the number of patients eligible to join a practice and in some cases also to deregister existing patients, have risen with 26 made between April and October 2014 compared to 30 for the whole of 2013/14. Only 15 have been approved.

In November 2014 Mr Justice Popplewell declared that NHS England “has acted unlawfully by reason of its failure to make arrangements for the involvement of patients in primary care commissioning decisions as required by the National Health Service Act 2006”. The case involved the decision to scrap minimum practice income guarantee. Richard Stein, a partner at Leigh Day, said the declaration could mean that patients would have to be involved in discussions on changes to the GP contract.

NHS England awarded a 4-year contract to Capita to become sole provider of administrative services including payment administration, management of medical records, and eligibility lists for practitioners for GPs, opticians and dentists across the UK in June 2015.

See also General medical services

Information technology

The organisation was reported to be developing a strategy to support the use of personal health records in June 2015. This, it is hoped, could achieve up to £3.4 billion in annual efficiency savings by 2020. In April 2016 it published an index of digital maturity, where each of the 239 NHS trusts assessed its own "readiness", "capabilities" and "Enabling infrastructure".

Specialist commissioning

Specialised services are those provided in relatively few hospitals, accessed by comparatively small numbers of patients but with catchment populations of usually more than one million. These services tend to be located in specialised hospital trusts that can recruit a team of staff with the appropriate expertise and enable them to develop their skills.

NHS England is responsible for commissioning £15.6 billion of specialised services to meet a wide range of health and care needs. These include a range of services from renal dialysis and secure inpatient mental health services, through to treatments for rare cancers and life threatening genetic disorders. The commissioning of specialised services is a prescribed direct commissioning responsibility of NHS England.

Four factors determine whether NHS England commissions a service as a prescribed specialised service. These are:

• The number of individuals who require the service;
• The cost of providing the service or facility;
• The number of people able to provide the service or facility and
• The financial implications for Clinical Commissioning Groups (CCGs) if they were required to arrange for provision of the service or facility themselves.

The ambition of NHS England is to bring equity and excellence to the provision of specialised care and treatment. This is achieved through a commissioning process which:

• is aligned with the priorities of NHS England as set out within the NHS Mandate and the strategic way forward within the Five Year Forward View;
• is patient-centred and outcome based. The patient must be placed at the centre of planning and delivery. Commissioners, working with providers, must deliver improved outcomes for them across each of the five domains of the 2013/14 NHS Outcomes Framework;
• is fair and consistent throughout the country, ensuring that patients have equal access to services regardless of their location, and;
• Improves value, productivity and efficiency.

The Specialised Commissioning directorate of NHS England takes a consistent approach to central planning of specialised services which is delivered locally. It works to raise the standards of care for all patients receiving treatment for rare and specialised conditions, ensuring that patients have equal access to services regardless of their location.

Arbitration

The organisation's responsibilities include arbitration in disputes between clinical commissioning groups and NHS trusts.

Funding of Clinical Commissioning Groups

NHS England allocates funding (of £69.5 billion in 2016/7) to CCGs in accordance with a funding formula. Until 2016 progress towards the amount indicated by the formula from the historical allocation was very slow, and CCGs which were above their allocation did not actually suffer a reduction. From April 2016 however CCGs with more than 10% above their fair share will receive "flat cash" - an effective reduction. This will also ensure than no CCG is more than 5% below its target allocation in 2016/7.

External links

• NHS England