News / Tough decisions loom on specialised services

In a report published today, the committee said NHS England faced tough choices on specialised services if it is to keep the services within budget. It said the specialised services budget increased from £13bn in 2013/14 to £14.6bn in 2015/16 – an average annual increase of 6.3%. Over the same period the overall NHS budget increased by an average of 3.5% a year. Specialised services now account for around 14% of the total NHS budget.

The report, NHS specialised services, called on NHS England to take action in three areas, ensuring:

• New drugs and medical equipment are affordable
• Services are delivered cost-effectively
• Demand for the specialised services it commissions is better managed.

 

When taking action to control spending, commissioners should work with NHS acute providers to avoid adding unduly to their financial pressures.

The PAC said NHS England and the Department of Health may have painted an unduly healthy picture of the state of commissioning’. It was disappointed that, three years after taking responsibility for specialised services, NHS England did not have consistent information from all providers on cost, access, outcomes and service efficiency. NHS England must ensure it is using improved data to compare providers and increase value for money by April next year, it said. The data should link spend by service to quality and patient outcomes and experience.

It also insisted that NHS England publish, by October, how specialised services fit into the Five-year forward view and the £22bn efficiency savings the health service must make by 2020/21.

The report also called for consistency, equity and transparency in decisions on specialised services commissioning. It said that NHS England should outline the roles played by its advisory committees and decision-making bodies by September, how decisions will be documented and when and to whom they will be made available.

PAC chair Meg Hillier (pictured) said previous its reports had highlighted the lack of a convincing plan to close the efficiency gap and avoid a ‘black hole’ in NHS finances.

She continued: ‘Alarm bells therefore ring when we examine an area of the health service that, while benefiting from above average budget increases, is nevertheless failing to keep within spending targets.

‘Every pound counts and savings, where there is scope to make them, can be used to help more patients. NHS England can and should do more to get best value from spending on specialised services.’

She added that, as a matter of urgency, NHS England must review the way it commissions the services and make better use of the data available to ensure public money is spent efficiently.

‘Rapid change is needed and we will expect to see work undertaken to address our recommendations over the summer,’ she said.