The CCG receives a fixed budget from central Government and must arrange for the provision of healthcare to the extent it considers necessary to meet the reasonable requirements of its patients, subject to the statutory duty to stay within its allocated resources.
Directly commissioned services include those provided through primary, secondary and tertiary care providers, the independent sector, voluntary agencies and independent NHS contractors.
The CCG seeks to take decisions about which services to commission through a systematic approach which is centred on the needs of the patient but which fairly distributes services across different patient groups. Given resource constraints, the CCG cannot meet every healthcare need of all patients within its area of responsibility. The fact that the CCG takes a decision not to commission a service to meet a specific healthcare need due to resource constraints does not indicate that the CCG is breaching its statutory obligations. The mechanism through which investment and disinvestment decision are taken is through a range of CCG processes.
This priority setting process is supported by a series of generic commissioning policies which can be accessed below:
- Ethical framework for priority setting and resource allocation
- Experimental and unproven treatments policy
- Implementation and funding of guidance produced by NICE
- Patients changing responsible commissioner
- In-Year Service Developments and the CCG’s approach to treatments not yet assessed and prioritised
- On-going access to treatment following the completion of industry sponsored clinical trials or funding
- On-going access to treatment following the completion of a trial explicitly funded by the CCG
- On-going access to treatment following the completion of non-commercially funded clinical trials covered by Department of Health
- On-going access to treatment following a ‘trial of treatment’ which has not been sanctioned by the CCG for a treatment which is not routinely funded or has not been formally assessed and prioritised
- Defining the boundaries between NHS and private healthcare