Integrated care: impact on commissioning

Integrated care: what does it mean for commissioning?  | The Nuffield Trust 

This article looks at the risks and opportunities for commissioning as integrated care develops and evolves. Topics discussed include:

  • What are ACSs and ACOs?

  • NHS commissioning to date

  • The limited effectiveness of the market

  • Commissioning in integrated care systems

Additional link: Commissioning: the times are a changing

Accountable care organisations contracts

NHS England has announced it will launch a consultation on the contracting arrangements for Accountable Care Organisations.  The consultation will set out how the contract fits within the NHS as a whole, address how the existing statutory duties of NHS commissioners and providers would be performed under it, and will set out how public accountability and patient choice would be preserved.

Commissioning continuing healthcare

This document outlines key learning points from CCGs that have achieved significant  efficiency savings and improvements for patients in the provision of NHS continuing healthcare services in their local area | NHS Clinical Commissioners 

NHS continuing healthcare: Effective commissioning approaches identifies six national actions that will support the local delivery of Continuing Healthcare (CHC):

Image source:
  1. Recognise and value the CHC workforce
  2. Develop a clear national CHC narrative
  3. Develop a pre-checklist process to help address workload pressures
  4. Develop national guidance that supports local process
  5. Establish a national process for sharing legal advice where appropriate between CCGs
  6. Establish a policy feedback forum to ensure effective links with the reality of delivery on the ground

Full reference: NHS continuing healthcare: effective commissioning approaches

Tackling loneliness and social isolation

Tackling loneliness and social isolation: the role of commissioners | The Social Care Institute for Excellence 


This briefing draws on discussion from a seminar held in September 2017 to explore the opportunities and barriers faced by commissioners seeking to address social isolation in older people.  It also looks at previous research and evaluations in this field.

The paper:

  • identifies the evidence that points the way to a better understanding of effective interventions
  • provides examples of practice emerging in different parts of the country
  • examines what needs to happen next in order to create a more conducive
    commissioning environment.

Full briefing: Tackling loneliness and social isolation: the role of commissioners

Additional link: SCIE press release

Reducing prescriptions for over-the counter medicines

NHS England is launching a public consultation on reducing prescribing of over-the-counter medicines for 33 minor, short-term health concerns.


These prescriptions include items for a condition:

  • That is considered to be self-limiting and so does not need treatment as it will heal of its own accord;
  • Which lends itself to self-care, i.e. that the person suffering does not normally need to seek medical care but may decide to seek help with symptom relief from a local pharmacy and use an over the counter medicine.

Vitamins/minerals and probiotics have also been included in the consultation proposals as items of low clinical effectiveness which are of high cost to the NHS.

NHS England has partnered with NHS Clinical Commissioners to carry out the consultation after CCGs asked for a nationally co-ordinated approach to the development of commissioning guidance in this area to ensure consistency and address unwarranted variation.  The intention is to produce a consistent, national framework for CCGs to use. The consultation closes on the 14 March 2018.

View the full consultation document here