Commissioning Policies

On July 1st 2022 NHS Cheshire and Merseyside Integrated Care Board (NHS Cheshire and Merseyside) became the new statutory body responsible for ensuring health care services are available to meet the reasonable needs of the people of Cheshire and Merseyside.

NHS Cheshire and Merseyside is required to have clinical commissioning policies that set out what services are available for our population as a whole and which are based on eligibility criteria.

As the successor body to the nine former Clinical Commissioning Groups (CCGs) within Cheshire and Merseyside, we have inherited each CCG’s commissioning policies which set out what services are available for the CCG’s population as a whole and which are based on eligibility criteria.

Each CCG had a suite of policies with regards to the commissioning of various health care services. Having considered each policy, it is evident that, in respect of the commissioning of some health care services, a degree of variation existed between the CCGs. Where this is the case, it is acknowledged by NHS Cheshire and Merseyside that there is a need to develop and implement a single suite of commissioning policies across Cheshire and Merseyside as soon as possible so that the commissioning of these services is consistent and applicable across Cheshire and Merseyside going forwards.

Where there is no such variation between the CCG policies, NHS Cheshire and Merseyside has nonetheless determined that, in view of the age of the policies, there is still a need for those policies to be reviewed and for a single suite of commissioning policies across Cheshire and Merseyside to be developed.

Developing a single Cheshire and Merseyside wide suite of commissioning policies is a complex programme of work and requires formal processes to be followed, including a review and consideration of the latest evidence based clinical practice and engagement with patients, the public and other key stakeholders across Cheshire and Merseyside, including with local authorities.

In view of the variation between existing policies, and in some cases the age of the existing policies, it is essential that any single suite of commissioning policies for Cheshire and Merseyside reflects and is based on up-to-date clinical practice and research, but also takes into account the current commissioning landscape, the changing needs of the Cheshire and Merseyside population and the duties on NHS Cheshire and Merseyside to ensure that health care services are available to meet the reasonable needs of the population.

In our previous statement on this matter published on July 1st 2022 we stated that we planned to be in a position to adopt a single suite of commissioning policies across Cheshire and Merseyside by April 1st 2023. Having now considered each policy in some detail, it has become clear that in view of the work involved in creating a single suite of policies across the NHS Cheshire and Merseyside footprint, we will not be in a position to carry out this work and adopt those policies by April 1st 2023.

We have identified 62 (of 112) policies where there is little or no variation between the previous CCG policies and, having reviewed those policies, they are in line with the latest evidence base. It is therefore intended that those policies are harmonised into a policy applicable across Cheshire and Merseyside. Following the review and subsequent endorsement of the completed Quality Impact Assessments in relation to those policies and approval of this approach by the Quality and Performance Committee of NHS Cheshire and Merseyside (held on January 19th 2023), we are now in a position to harmonise 50 of those policies, as detailed within Appendix 1 (below). The Quality Impact Assessments in relation to the remaining 8 of those 62 policies are not yet complete, but we hope to complete those shortly so that those policies can also be harmonised in the same way. The harmonisation process will produce equivalent policies for NHS Cheshire and Merseyside, applicable to the population across the NHS Cheshire and Merseyside area.

The remaining policies, following review, will require more detailed consideration and work to ensure that the harmonisation of these policies results in an NHS Cheshire and Merseyside single suite of policies which are up to date and reflect the latest evidence base. This work is in progress and, as appropriate, NHS Cheshire and Merseyside will engage with patients, the public and other key stakeholders across Cheshire and Merseyside as part of this process.

We very much hope to be in a position to adopt a single suite of commissioning policies across Cheshire and Merseyside by early 2024, and we will publish new policies as soon as these are completed and have been through the relevant engagement and governance processes required.

In the meantime, NHS Cheshire and Merseyside will continue to adopt and operate the CCG policies it has inherited at Place/borough level, which means that there is currently no change in commissioning policy for local people resident in those Places/boroughs from what was in place prior to July 1st 2022.

We will continue to report progress on the development of the new Cheshire and Merseyside wide policies through regular updates via our website and through our local networks within communities.

Appendix 1 - Policies to be harmonised, following completed Quality Impact Assessments and approval by the Quality and Performance Committee (on 19/01/23):