Together for Short Lives' response to Public Accounts Committee

Together for Short Lives has called on the government and NHS England to implement the recommendations of a new Parliamentary report and improve the way it commissions specialised care for children and young people with the most complex life-shortening conditions.

Specialised services are those provided in relatively few hospitals and accessed by comparatively small numbers of people. 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. While most general health services in England are commissioned by CCGs, NHS England is directly responsible for specialised services.

The report, published by the House of Commons Committee of Public Accounts, follows an inquiry into the way in which NHS England plans and funds specialised health services. The report finds that:

  • NHS England has yet to overcome the barriers to collaborative commissioning with clinical commissioning groups (CCGs)
  • NHS England does not have the information - on costs, access and outcomes - necessary to assess how to improve services
  • NHS England still does not have a clear plan for the future configuration and delivery of specialised services.

The committee made a series of recommendations including:

  • NHS England should engage with CCGs to address barriers to collaborative commissioning and, by October 2016, set clear milestones and timelines by which measurable service change and patient benefit from this initiative will be demonstrated
  • NHS England should set out publicly, by October 2016, how specialised services fit within the NHS Five Year Forward View; the £22 billion efficiency challenge that the NHS faces; and the transformation funding aimed at addressing provider sustainability
  • By April 2017, it should use this data to link spend, by service provided, to service quality, patient outcomes and patient experience; to allow clear comparison between different providers; and to improve value for money.

Commenting on the committee’s report, Shaun Walsh, Executive Director of External Affairs at Together for Short Lives said:

“The committee’s findings support our own view that specialised commissioning is just not working for children with life-shortening conditions as it should be. Together for Short Lives’ own evidence shows that some commissioners remain in the dark about what they are responsible for. Providers tell us that they are unable to access funding for providing specialised services.

“We call on the government to implement the committee’s recommendations and to work with NHS England and others to make clear to CCGs and local authorities who is responsible for planning and funding children’s palliative care. We also ask them to work with us to help commissioners and providers to work more closely together to make sure that children and young people with the most complex needs get the crucial, specialised care they need.

Together for Short Lives is a member of the Specialised Healthcare Alliance, which submitted evidence to the inquiry.

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