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<p>The total spend on commissioning specialised services was £22.7 billion in 2022/23
and £25 billion in 2023/24. As formal delegation of specialised services to integrated
care boards (ICBs) begins from 1 April 2024, all spend on commissioning these services
in previous years has been the responsibility of NHS England, and not the ICBs. For
2024/25, NHS England is delegating £5.3 billion of commissioning resource to ICBs
in the three regions, where delegation will begin from April 2024. This figure excludes
high-cost drugs and devices spend.</p><p>The nine joint committee arrangements arose
from a robust process, which included a readiness assessment, the Pre-Delegation Assessment
Framework, made between the ICBs and NHS England regional teams, followed by a National
Moderation Panel, and final decision taken by the NHS England Board. The NHS England
Board papers for February 2023, December 2023, and March 2024 are available, respectively,
at the following links:</p><p><a href="https://www.england.nhs.uk/wp-content/uploads/2023/02/board-2-feb-23-item-7-delegation-of-spec-comm.pdf"
target="_blank">https://www.england.nhs.uk/wp-content/uploads/2023/02/board-2-feb-23-item-7-delegation-of-spec-comm.pdf</a></p><p><a
href="https://www.england.nhs.uk/long-read/specialised-commissioning-2024-25-next-steps-with-delegation-to-integrated-care-boards/"
target="_blank">https://www.england.nhs.uk/long-read/specialised-commissioning-2024-25-next-steps-with-delegation-to-integrated-care-boards/</a></p><p><a
href="https://www.england.nhs.uk/long-read/specialised-commissioning-update-on-specialised-services-for-delegation/"
target="_blank">https://www.england.nhs.uk/long-read/specialised-commissioning-update-on-specialised-services-for-delegation/</a></p><p>The
process concluded that a transitional year of joint commissioning would offer the
most secure and stable transition towards delegation. There is a comprehensive programme
structure in place to support the ICBs in the four regions that are working towards
delegation in April 2025, to support them in being ready to take on the responsibilities.
NHS England is continuing to work alongside ICBs to ensure that delegation agreements
are in place, including ensuring appropriate collaborative arrangements are developed
to support ICB commissioning of specialised services. These arrangements will be monitored
by NHS England through its assurance processes for specialised services.</p><p>A webinar
series for commissioning staff, including colleagues in ICBs, was delivered in 2023
across different aspects of specialised services, and there are additional webinars
planned in 2024. There has been, and will continue to be, local engagement between
regional commissioning teams and ICB teams, as the future operating model is co-developed.
A suite of support materials has been shared with teams and continues to be updated.
As examples, these include: Commissioning Change Management Business Rules; Finance
and Accounting Standard Operating Procedure; and the Contracting Standard Operating
Procedure.</p><p>NHS England develops services specification and clinical policies
through its Clinical Reference Groups. There are 250 published service specifications
which include clinical pathway, quality, and other relevant standards, which are specific
to the clinical service. Regional commissioning teams, overseen by the statutory joint
committees, are responsible for implementing the specifications in their commissioning
of services, along with assessing compliance against national standards. NHS England
has developed Specialised Services Quality Dashboards alongside service specifications,
which provide additional data to monitor the quality of services.</p><p><strong> </strong></p>
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