Professional Documents
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The Clarity of Commissioning
The Clarity of Commissioning
Contents
Executive Summary
Introduction
1. Online Disclosure of Information
2. Freedom of Information
3. Key Findings and Analysis: Out-sourcing of Contracts
4. Summary and Conclusion
Recommendations
Notes
References
2
3
3
3
4
9
9
10
11
Executive Summary
This report has surveyed the 11 CCGs in the North East of England in terms of online access to information,
responding to Freedom of Information requests and out-sourcing of contracts.
Online access to information is adequate but in need of some improvement. Responses to FoI requests are
good but could reach a very high standard with some adjustments. Finally, the out-sourcing of contracts is
an area of concern, however, the involvement of the private sector appears to be low relative to overall
levels of expenditure for each CCG.
Recommendations:
1.
Access should be provided to a disclosure log which archives responses to FoI requests and
this should be easily navigated from the homepage.
2.
Responses to FoI requests which contain quantitative, financial or a combination of both
types of data should be provided in an MS Excel spreadsheet format.
3.
Aggregated data of out-sourced contracts should be published on CCG websites and should
clearly show the type of contract awarded.
Introduction
A previous report, The Transparency of Trusts, examined information sharing in NHS Foundation Trusts.
Trust capacity for information sharing, in this report, was found to be quite poor in a number of cases.
Information and data sharing in Clinical Commissioning Groups (CCGs), however, examined in this report, is
demonstrated to be considerably more appropriate and effective.
CCGs are clinically led groups that include all of the GP groups in their geographical area. The aim of this is
to give GPs and other clinicians the power to influence commissioning decisions for their patients. They are
overseen by NHS England (including its Regional Offices and Area Teams). These structures manage primary
care commissioning, including holding the NHS Contracts for GP practices.
Each CCG has a constitution and is run by its governing body. Each has to have an accountable officer
responsible for the CCGs duties, functions, finance and governance. Most CCGs initially appointed former
PCT managers to these posts. Only a quarter of accountable officers were GPs in October 2014, but 80% of
CCG Chairs were GPs. However, only half of GP practices said they felt involved in CCG decision-making
processes (Health Service Journal 2014).
For the purposes of this report, CCGs, in the North East of England, were given a single information request
which they responded to in a systematic and timely manner. Follow up queries, on some information were
also responded to in a similar way. MS Excel was used to analyse responses and produce the figures used in
the report.
The report is divided into 4 sections:
1.
2.
3.
4.
Online Disclosure of Information: including details of publication schemes and disclosure logs.
Freedom of Information: including details of FoI requests, their processing and responses.
Key Findings and Analysis: Out-sourcing of Contracts: including details of out-sourced contracts.
Summary and Conclusion: including recommendations for improving services.
2. Freedom of Information
2.1. Freedom of Information Requests
All 11 CCGs, in the North East, were asked the following question, on the 1st of December 2014:
Could you please provide me with a list of all health service
contracts allocated in the financial year 2013/14?
This list should contain the following details:
1.
Specific service provided
2.
Name of contractor
3.
Date contract commenced
4.
Total value of contract awarded
The speed of response was exemplary with all requests replied to within 15 rather than the prescribed 20
days allowed under the Freedom of Information Act (2000).
350
300
250
200
150
100
50
0
35
30
25
20
15
10
5
Number
Value
Sunderland
South Tyneside
South Tees
Northumberland
North Tyneside
North Durham
Newcastle West
Newcastle East
50
median age ranges of any CCG in England at 31.7 (Office for National Statistics 2013). This may account for
the relatively low level of expenditure on acute services.
250
200
150
100
50
0
3,000
2,500
2,000
1,500
1,000
500
0
500
400
300
200
100
0
Recommendations
1. Access should be provided to a disclosure log which archives responses to FoI requests and this
should be easily navigated from the homepage.
2. Responses to FoI requests which contain quantitative, financial or a combination of both types of
data should be provided in an MS Excel spreadsheet format.
3. Aggregated data of out-sourced contracts should be published on CCG websites and should clearly
show the type of contract awarded.
NOTES
1. The IG Toolkit is an online system which allows NHS organisations and partners to assess themselves
against Department of Health Information Governance policies and standards. The toolkit is a product of
the Information Governance Alliance (IGA) The IGA is a group of national health and care organisations that
are working together to provide a joined up and consistent approach to information governance. The core
members of the IGA are the Department of Health, NHS England, Public Health England and the Health and
Social Care Information Centre. The IGA aims to improve information governance in health and care by:
Providing suport to front line staff, managers and their organisations to help them handle personal
information confidently and in the best interests of people who use their services
Developing the capacity and capability of the information governance profession by providing
expert advice and a knowledge sharing network
2. Types of service contracts:
Alternative Provider Medical Services (APMS): APMS provides the opportunity for locally negotiated
contracts allowing CCGs to contract with non-NHS bodies.
Any Qualified Provider (AQP): is a means of commissioning certain NHS services in England. CCGs
determine the services to be commissioned as AQP. The declared intention is to increase patient choice. All
providers must meet the qualification criteria set for a particular service and once qualified their service will
appear on choose and book for patients to select.
NHS Standard Contract (NHSSC): is mandated by NHS England for use by CCGs for all contracts for
healthcare services other than primary care.
Other types of agreement:
Service Level Agreement (SLA): is where a service is formally defined. Particular aspects of the service scope, quality, responsibilities - are agreed between the service provider and the service user. A common
feature of an SLA is a contracted delivery time.
Grant-aid: is awarded to the voluntary sector, who, in return expect to operate with a level of
independence in service delivery.
3. A view expressed in a personal letter from David Gallagher to Bridget Phillipson MP (23/12/2014).
References
Health Service Journal (2014) Online at: http://www.hsj.co.uk/
Information Commissioners Office (2000) What is the Freedom of Information Act Online at:
https://ico.org.uk/for-organisations/guide-to-freedom-of-information/what-is-the-foi-act/
Office for National Statistics (2013) Statistical Bulletin Online at:
http://ons.gov.uk/ons/publications/index.html