CCG mergers - news stories

Three more CCGs vote to merge next year

HSJ 14 February 2020

• South Warwickshire, Warwickshire North, and Coventry and Rugby CCGs will now apply for approval from NHS Improvement/England, with a view to merging in April 2021.

The CCG map after new wave of mergers
HSJ 5 February 2020

• Analysis by HSJ shows that NHS England has approved the merger of 74 existing CCGs to establish 18 new ones as of April 2020. It means the total number of CCGs is due to fall from 191 to 135.

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What record NHS investment means for each of my priorities - speech

What record NHS investment means for each of my priorities [Speech]
Matt Hancock 18 December 2019

• "So my priorities, which will apply to each and every part of the health and care system, are:
• Prevention: because prevention is better than cure.
• People: because we need more people working smarter.
• Technology: because patients and clinicians demand better.
• Infrastructure: because buildings matter too."

Matt Hancock - Secretary of State for Health July 2018

Matt Hancock - Secretary of State for Health and Social Care, appointed 9 July 2018

Health Secretary speeches and press releases.

News/commentaries

What have the parties pledged on health and care?

What have the parties pledged on health and care?
Kings Fund 28 November 2019

• A summary of the manifesto commitments of the three main parties for the NHS, social care and public health.

Artificial Intelligence: How to get it right. Putting policy into practice for safe data-driven innovation in health and care

Artificial Intelligence: How to get it right. Putting policy into practice for safe data-driven innovation in health and care 
NHSX  October 2019

• This report gives a considered and cohesive overview of the current state of play of data driven technologies within the health and care system, covering everything from the local research environment to international frameworks in development. Informed by research conducted by NHSX and other partners over the past year, it outlines where in the system AI technologies can be utilised and the policy work that is, and will need to be do.
• It includes a wide range of case Studies from the NHS and commercial providers.

Intellectual property and Brexit

Intellectual property and Brexit
Intellectual Property Office 10 October 2019

• Guidance on trade marks, designs, patents right law, and exhaustion of IP rights after Brexit.

NIHR Applied Research Collaborations (ARCs)

NIHR Applied Research Collaborations (ARCs) (launched October 2019)

• NIHR ARCs (previously NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRCs), support applied health and care research that responds to, and meets, the needs of local populations and local health and care systems. 
• The 15 local partnerships between NHS providers, universities, charities, local authorities, Academic Health Science Networks and other organisations also undertake implementation research to increase the rate at which research findings are implemented into practice. 
• Research priorities for the different ARCs.

Clinical service accreditation - statement of intent

Clinical service accreditation - statement of intent
BSI, HQIP, UKAS October 2019

• BSI, Healthcare Quality Improvement Partnership (HQIP) and the United Kingdom Accreditation Service (UKAS) have published a statement setting out a shared intent to improve clinical services through accreditation. 
• Their statement outlines their commitment to working together to:
• improve the quality and effectiveness of healthcare by providing clinical services with an infrastructure and a set of requirements that enables a structured approach to quality improvement against which they can be assessed
• encourage further development of certification schemes in clinical services and to have the providers of those schemes accredited against national standard
• integrate these initiatives with regulatory bodies (such as the Care Quality Commission (CQC) and other inspection and improvement processes so that commissioners, service providers and service users have a mechanism that supports quality improvement and provides assurance.

Artificial Intelligence: How to get it right

Artificial Intelligence: How to get it right
NHSX October 2019

• Subtitled "Putting policy into practice for safe data-driven innovation in health and care", this report gives a considered and cohesive overview of the current state of play of data-driven technologies within the health and care system. It discusses a governance framework (including Code of Conduct for Data-Driven Health and Care Technology in particular Algorithmic Explainability, Evidence for Effectiveness and Commercial Strategy), the regulation journey, Data agreements, adoption and spread and the NHS AI lab.
• Figure 2: Proportion of products likely or very likely to be ready for at scale deployment in 1,3 or 5 years from the UK State of the Nation Report
• Figure 3: Areas of greatest development in AI/data-driven technologies
• Figure 4: Consideration of ethical issues associated with algorithms during the development process
• Figure 6: current regulator journey map for data driven technologies in health and care
• Appendix: Case Studies

Health Secretary: How we make public health fit for the future

Health Secretary: How we make public health fit for the future

PHE Conference September 2019

• In his address to the PHE conference, health secretary Matt Hancock said “personalised prevention should be the guiding principle of public health in the 2020s”. This meant “government, both local and national, working with the NHS, putting prevention at the heart of our decision-making”.... "We must harness the predictive power of genomics, and the data-crunching power of AI so we can get to people before they have a problem”.

Advancing our health: prevention in the 2020s - consultation document

Advancing our health: prevention in the 2020s - consultation document
Cabinet Office and DHSC 22 July 2019

• The DHSC prevention green paper to "help people live healthier, happier lives for longer" is now open for consultation. Online survey. Closing date 14 October 2019.
• Proposal highlights:

NHS Long Term Plan Implementation Framework

NHS Long Term Plan Implementation Framework 
NHS England 27 June 2018

(Accompanying NHS England/ NHS Improvement Board paper)

• On publication of the LTP in January 2019, an Implementation Framework was promised which would support sustainability and transformation partnerships (STPs) / integrated care systems (ICSs) to undertake strategic planning. Five year strategic plans, 2019/20 – 2023/24, are expected by November and will be fed into the national plan by the end of 2019. Plans must set out how STPs will develop to become an ICS by April 2021.
• The Framework sets out expectations and the support available to systems from national and regional teams and will put into practice the new operating model for NHS England and Improvement.
• Expectation are that plans ”explicitly set out how the additional funding being invested will deliver real improvements for their populations”, and that plans are:
• Clinically-led
• Locally owned
• Based on realistic workforce planning
• Financially balanced and delivering financial recovery
• Delivering all the commitments within the Long Term plan
• Phased over the full five years reflecting local priorities and different starting points
• Reducing local health inequalities and unwarranted variation, (including disadvantaged or vulnerable groups and those with learning disabilities/autism).
• Focused on prevention
• Engaged with Local Authorities
• Driving innovation
• Other key areas for consideration include workforce, digitally enabled care, and financial planning assumptions to meet the financial tests set out in the Long Term Plan.

Digital-First Primary Care Policy

Digital-First Primary Care Policy: consultation on patient registration, funding and contracting rules
NHS England 27 June 2019

• This document describes the proposals to reform patient registration, funding and contracting rules to ensure patients have both choice as well as access to integrated care; and to harness the potential of digital providers to help with our workforce shortages in a way that helps our most under-doctored and deprived communities. It sets out options and proposals for reform and invite views.
• Consultation closes 23 August 2019

Boosted Accelerated Access Collaborative

Boosted Accelerated Access Collaborative
NHS England ACC Board meeting paper 2, 26 June 2019

• A summary of the the key elements of the innovation ecosystem of an expanded Accelerated Access Collaborative (AAC) including objectives and deliverables.
• The AAC’s existing role in identifying and supporting high quality innovations will be maintained but the AAC will take a more flexible approach to the criteria used for filtering products to include products which may not be cost-neutral in-year, but which are viewed to be clinically beneficial and cost-effective.
• The AAC Delivery Unit will be co-located with NHS England’s Specialised Commissioning and Commercial Medicines functions.
• Objectives:
• Create a “single front door” to the innovation ecosystem
• Bring together horizon scanning for the best new innovations
• Develop an approach to local and national demand signalling
• Establish globally leading testing infrastructure
• Improve the quality of adoption and spread support for the best new innovations
• Deliver better practical innovation support funding

NHSX: priorities, work ongoing and programmes closing [blog Matthew Gould]

NHSX: giving patients and staff the technology they need, [blog by Matthew Gould, CEO NHSX]
Technology in the NHS [healthtech blog] 24 June 2019

• NHSX priorities going forward:
• reducing the burden on clinicians and staff, so they can focus on patients
• giving people the tools to access information and services directly
• ensuring clinical information can be safely accessed, wherever it is needed
• aiding the improvement of patient safety across the NHS
• improving NHS productivity with digital technology
• focus on standards and platforms that other innovators can build on.
• 10 major transformation pieces of work going forward:
1. NHS app and citizen ID
2. digital child health and maternity
3. integrating community providers (including pharmacists, optometrists, dentists and ambulances)
4. screening
5. booking, referrals and appointments management
6. standards (including medication standards)
7. primary care
8. urgent and emergency care
9. social care
10. local capability (including LHCR, HSLI, GDEs and Carter money)
• Programmes that are being closed include:
• NHS Wifi, which was successfully delivered in March 2019
• Access to Service Information: which is moving to live on the basis that the team will deliver a Directory of Services that will function as a canonical data register, as well as a bookings and referrals management system
• Digitising Community Pharmacy: which is completing the Electronic Prescription Service and moving to live
• Medicines Data and Integrating Pharmacy Across Care Settings: these programmes are stopping. Their aims will be incorporated into our work on interoperability, as well as a specific piece of work on linking pharmacists, optometrists and dentists into mainstream NHS processes
• Widening Digital Participation project

NHS Long-term Plan: legislative proposals

NHS Long-term Plan: legislative proposals
Health and Social Care Select Committee 24 June 2019

• The Committee found that NHS England and NHS Improvement proposals  for legislative changes to the Health and Social Care Act 2012 in many cases continue the direction of travel towards a more integrated collaborative and placed-based system. It broadly supports NHS England and NHS Improvement’s proposals to:
• to promote collaboration and lessen the role of competition in the NHS, especially the proposal to repeal section 75 of the Health and Social Care Act 2012 and revoke the regulations made under it;
• remove the Competition and Market’s Authority’s role in mergers of foundation trusts;
• ease the burden procurement rules have placed on the NHS, ensuring commissioners have discretion over when to conduct a procurement process, with the inclusion of a ‘best value’ test; and
• allow greater flexibility locally over payment systems.
• However the Committee comments that the plans remains too NHS-centric rather than looking at the wider system with which it seeks to integrate and that the Department of Health and Social Care, NHS England and NHS Improvement should be clearer about the roles local government, the voluntary and community sector and independent providers should play in the future of the NHS.
• Themes of the report are competition, integrated care, NHS leadership, and Cross-party endorsement of legislative proposals

The changing face of clinical commissioning

The changing face of clinical commissioning
NHS Clinical Commissioners 23 May 2019

• The report highlights the work of CCGs to drive through innovations and improvements across health and social care and the key strengths which should be retained within the new structures proposed by the NHS Long Term Plan.

Fit for the Future: A vision for general practice

Fit for the Future: A vision for general practice
RCGP 21 May 2019

• A presentation of the College's vision of what general practice will look like in 2030. Themes are around revitalising the profession, the expanded team and their role in a sustainable NHS.
• The potential benefits of digital technology outlined include the use of AI to
• Improving triage for patients presenting to acute settings and those with long-term
• conditions who require regular contact with their GP
• Flagging ‘at risk’ patients automatically
• Enhancing diagnostic decision-making
• Identifying potential treatment pathways along with their risks and benefits
• Assessing the severity of needs and suggesting treatment options
• Automating routine administrative tasks

Population health (p35)

"By 2030, GP networks will be able to consistently take a proactive ‘population health’ approach, rather than reactively struggling to manage demand. Evidence from at scale care models across the UK and abroad highlights the vital importance of investing in real-time data analytics. With the aid of insight from health data, GPs will have a comprehensive understanding of the health needs of the populations they serve, undertake risk stratification and work at both an individual and community level to tackle health inequalities. Networks will design preventative and anticipatory care services to help achieve desired patient outcomes – for example, falls prevention services or comprehensive community matron services, which can reduce the risk of unscheduled hospital admissions."

Simon Stevens lecture to the RSM

"The NHS and society" 2019 Stevens lecture - Simon Stevens [Subscription required]
Royal Society of Medicine 20 May 2019

• Edited highlights of Simon Stevens' speech to the RSM by Alastair Mclellan (HSJ editor) .
• Maintaining NHS efficiency; Helping people stay at or return to work; Rethinking the reasons for service change; Improving the regional loyalty of medical and nursing students; Supporting social care; Tracking health risks; Smoking, eating, drinking and gambling; Air pollution and climate change;

Accelerated Access Collaborative (AAC)

Accelerated Access Collaborative (AAC)
DHSC 2 May 2019

• The Accelerated Access Collaborative's (AAC) remit is to expand to become the umbrella body across the UK health innovation eco-system, providing more joined-up support for innovators and setting the strategy for innovation in the health system.
• AAC will be come a new unit in NHS England and NHS Improvement.
• The new AAC will:
• implement a system to identify the best new innovations and make sure the NHS is ready to make use of them
• set up a single point of call for innovators working inside or outside the NHS, so they can understand the system and where to go for support
• signal the needs of clinicians and patients, so innovators know which problems they need to solve
• establish a globally leading testing infrastructure, so innovators can generate the evidence they need to get their products into the NHS
• oversee a health innovation funding strategy that ensures public money is focused on the areas of greatest impact for the NHS and patients
• support the NHS to more quickly adopt clinically and cost-effective innovations, to ensure patients get access to the best new treatments and technologies faster than ever before