25.06.15
Specialised commissioning overspends led to ‘policy-paralysis’
Budget overspends in specialised commissioning after the introduction of the Health and Social Care Act led to ‘policy-paralysis’ that left many patients in limbo, delegates were told at the Commissioning Show yesterday.
John Murray, director of the Specialised Healthcare Alliance, said the Act did help clarify where responsibility lay for commissioning services, and it secured funding for prescribed services.
“It is good to have national specifications and commissioning strategies. But, it has to be said, a lot has gone badly,” he said. “There was a big budget overspend. This was, in part, because the budget hadn’t been properly calculated in the first place – the data provided by PCTs was largely not accurate; it was also due to extra activity by secondary care trusts; and the Cancer Drugs Fund (CDF) started to run out of control. Even last year, there was an overspend of about £220m in specialised [commissioning], more than half of that was due to the CDF.”
He added that this brought about “policy-making paralysis”.
“Frankly, for a couple of years NHS England almost stopped making decisions. But, as a result, an awful lot of patients were left in limbo across quite a large number of services.”
Murray did argue that there is absolutely no reason why CCGs shouldn’t commission specialised services – they just need to be de-prescribed by ministers, with bariatric surgery being a case in point.
Discussing the longer term future of specialised commissioning, Murray said: “I find the Five Year Forward View an interesting document because it scarcely mentions commissioning, but it does talk about the wider role of delivering integrated care. There is crucially, especially in terms of specialised commissioning, a lot of scope for better integration to be delivered by primary providers.”
Full coverage of this session and the entire Health + Care and Commissioning Show will be in the July/August edition of NHE.
NHE is the media partner of the Commissioning Show.