Overhaul of commissioning could hit specialised services delivery

The introduction of integrated care systems (ICSs) this summer, triggering a major overhaul of commissioning responsibilities, could have a negative impact on the delivery of specialised services – which range from chemotherapy, radiotherapy and kidney dialysis to treatment trials such as mitochondrial donation – across England, according to a group of major hospital trusts.

In a letter, leaked last week to HSJ, the Shelford Group of teaching and research trusts warned NHS England (NHSE) two months ago that the provision and quality of these services risked being diluted by “the wholesale [transfer] of commissioning of 80-90 per cent of specialised services to an ICS footprint”.

The group – which includes University College London, Imperial College Healthcare and Guy’s and St Thomas’ Trusts among its membership – suggested the changes could lead to a postcode lottery in provision. It highlighted the risk that ICSs will now “focus on high-volume services for their local population, leading to de-prioritisation of [such] services, and/or an inclination to support development of services within that ICS’ footprint, as opposed to at the optimal level for ensuring clinical quality”.

Full story in The Lowdown, 24 May 2022