Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment has she made of the adequacy of the progress towards full delegated commissioning for Integrated Care Boards by April 2025 in (a) the South West, (b) the South East, (c) London and (d) the North East.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

The total spend on commissioning specialised services was £22.7 billion in 2022/23 and £25 billion in 2023/24. As formal delegation of specialised services to integrated care boards (ICBs) begins from 1 April 2024, all spend on commissioning these services in previous years has been the responsibility of NHS England, and not the ICBs. For 2024/25, NHS England is delegating £5.3 billion of commissioning resource to ICBs in the three regions, where delegation will begin from April 2024. This figure excludes high-cost drugs and devices spend.

The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between the ICBs and NHS England regional teams, followed by a National Moderation Panel, and final decision taken by the NHS England Board. The NHS England Board papers for February 2023, December 2023, and March 2024 are available, respectively, at the following links:

https://www.england.nhs.uk/wp-content/uploads/2023/02/board-2-feb-23-item-7-delegation-of-spec-comm.pdf

https://www.england.nhs.uk/long-read/specialised-commissioning-2024-25-next-steps-with-delegation-to-integrated-care-boards/

https://www.england.nhs.uk/long-read/specialised-commissioning-update-on-specialised-services-for-delegation/

The process concluded that a transitional year of joint commissioning would offer the most secure and stable transition towards delegation. There is a comprehensive programme structure in place to support the ICBs in the four regions that are working towards delegation in April 2025, to support them in being ready to take on the responsibilities. NHS England is continuing to work alongside ICBs to ensure that delegation agreements are in place, including ensuring appropriate collaborative arrangements are developed to support ICB commissioning of specialised services. These arrangements will be monitored by NHS England through its assurance processes for specialised services.

A webinar series for commissioning staff, including colleagues in ICBs, was delivered in 2023 across different aspects of specialised services, and there are additional webinars planned in 2024. There has been, and will continue to be, local engagement between regional commissioning teams and ICB teams, as the future operating model is co-developed. A suite of support materials has been shared with teams and continues to be updated. As examples, these include: Commissioning Change Management Business Rules; Finance and Accounting Standard Operating Procedure; and the Contracting Standard Operating Procedure.

NHS England develops services specification and clinical policies through its Clinical Reference Groups. There are 250 published service specifications which include clinical pathway, quality, and other relevant standards, which are specific to the clinical service. Regional commissioning teams, overseen by the statutory joint committees, are responsible for implementing the specifications in their commissioning of services, along with assessing compliance against national standards. NHS England has developed Specialised Services Quality Dashboards alongside service specifications, which provide additional data to monitor the quality of services.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what (a) training and (b) support on specialised services is provided for staff working in integrated care boards in the (i) East of England, (ii) Midlands and (iii) North West following full delegation of commissioning in 2024-25.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

The total spend on commissioning specialised services was £22.7 billion in 2022/23 and £25 billion in 2023/24. As formal delegation of specialised services to integrated care boards (ICBs) begins from 1 April 2024, all spend on commissioning these services in previous years has been the responsibility of NHS England, and not the ICBs. For 2024/25, NHS England is delegating £5.3 billion of commissioning resource to ICBs in the three regions, where delegation will begin from April 2024. This figure excludes high-cost drugs and devices spend.

The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between the ICBs and NHS England regional teams, followed by a National Moderation Panel, and final decision taken by the NHS England Board. The NHS England Board papers for February 2023, December 2023, and March 2024 are available, respectively, at the following links:

https://www.england.nhs.uk/wp-content/uploads/2023/02/board-2-feb-23-item-7-delegation-of-spec-comm.pdf

https://www.england.nhs.uk/long-read/specialised-commissioning-2024-25-next-steps-with-delegation-to-integrated-care-boards/

https://www.england.nhs.uk/long-read/specialised-commissioning-update-on-specialised-services-for-delegation/

The process concluded that a transitional year of joint commissioning would offer the most secure and stable transition towards delegation. There is a comprehensive programme structure in place to support the ICBs in the four regions that are working towards delegation in April 2025, to support them in being ready to take on the responsibilities. NHS England is continuing to work alongside ICBs to ensure that delegation agreements are in place, including ensuring appropriate collaborative arrangements are developed to support ICB commissioning of specialised services. These arrangements will be monitored by NHS England through its assurance processes for specialised services.

A webinar series for commissioning staff, including colleagues in ICBs, was delivered in 2023 across different aspects of specialised services, and there are additional webinars planned in 2024. There has been, and will continue to be, local engagement between regional commissioning teams and ICB teams, as the future operating model is co-developed. A suite of support materials has been shared with teams and continues to be updated. As examples, these include: Commissioning Change Management Business Rules; Finance and Accounting Standard Operating Procedure; and the Contracting Standard Operating Procedure.

NHS England develops services specification and clinical policies through its Clinical Reference Groups. There are 250 published service specifications which include clinical pathway, quality, and other relevant standards, which are specific to the clinical service. Regional commissioning teams, overseen by the statutory joint committees, are responsible for implementing the specifications in their commissioning of services, along with assessing compliance against national standards. NHS England has developed Specialised Services Quality Dashboards alongside service specifications, which provide additional data to monitor the quality of services.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what estimate she has made of the proportion of specialised services that met national standards in the (a) 2022-23 and (b) 2023-24 financial years.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

The total spend on commissioning specialised services was £22.7 billion in 2022/23 and £25 billion in 2023/24. As formal delegation of specialised services to integrated care boards (ICBs) begins from 1 April 2024, all spend on commissioning these services in previous years has been the responsibility of NHS England, and not the ICBs. For 2024/25, NHS England is delegating £5.3 billion of commissioning resource to ICBs in the three regions, where delegation will begin from April 2024. This figure excludes high-cost drugs and devices spend.

The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between the ICBs and NHS England regional teams, followed by a National Moderation Panel, and final decision taken by the NHS England Board. The NHS England Board papers for February 2023, December 2023, and March 2024 are available, respectively, at the following links:

https://www.england.nhs.uk/wp-content/uploads/2023/02/board-2-feb-23-item-7-delegation-of-spec-comm.pdf

https://www.england.nhs.uk/long-read/specialised-commissioning-2024-25-next-steps-with-delegation-to-integrated-care-boards/

https://www.england.nhs.uk/long-read/specialised-commissioning-update-on-specialised-services-for-delegation/

The process concluded that a transitional year of joint commissioning would offer the most secure and stable transition towards delegation. There is a comprehensive programme structure in place to support the ICBs in the four regions that are working towards delegation in April 2025, to support them in being ready to take on the responsibilities. NHS England is continuing to work alongside ICBs to ensure that delegation agreements are in place, including ensuring appropriate collaborative arrangements are developed to support ICB commissioning of specialised services. These arrangements will be monitored by NHS England through its assurance processes for specialised services.

A webinar series for commissioning staff, including colleagues in ICBs, was delivered in 2023 across different aspects of specialised services, and there are additional webinars planned in 2024. There has been, and will continue to be, local engagement between regional commissioning teams and ICB teams, as the future operating model is co-developed. A suite of support materials has been shared with teams and continues to be updated. As examples, these include: Commissioning Change Management Business Rules; Finance and Accounting Standard Operating Procedure; and the Contracting Standard Operating Procedure.

NHS England develops services specification and clinical policies through its Clinical Reference Groups. There are 250 published service specifications which include clinical pathway, quality, and other relevant standards, which are specific to the clinical service. Regional commissioning teams, overseen by the statutory joint committees, are responsible for implementing the specifications in their commissioning of services, along with assessing compliance against national standards. NHS England has developed Specialised Services Quality Dashboards alongside service specifications, which provide additional data to monitor the quality of services.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what estimate she has made of the cost to (a) integrated care boards and (b) NHS England of commissioning specialised services in the (i) 2022-23 and (ii) 2023-24 financial years.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

The total spend on commissioning specialised services was £22.7 billion in 2022/23 and £25 billion in 2023/24. As formal delegation of specialised services to integrated care boards (ICBs) begins from 1 April 2024, all spend on commissioning these services in previous years has been the responsibility of NHS England, and not the ICBs. For 2024/25, NHS England is delegating £5.3 billion of commissioning resource to ICBs in the three regions, where delegation will begin from April 2024. This figure excludes high-cost drugs and devices spend.

The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between the ICBs and NHS England regional teams, followed by a National Moderation Panel, and final decision taken by the NHS England Board. The NHS England Board papers for February 2023, December 2023, and March 2024 are available, respectively, at the following links:

https://www.england.nhs.uk/wp-content/uploads/2023/02/board-2-feb-23-item-7-delegation-of-spec-comm.pdf

https://www.england.nhs.uk/long-read/specialised-commissioning-2024-25-next-steps-with-delegation-to-integrated-care-boards/

https://www.england.nhs.uk/long-read/specialised-commissioning-update-on-specialised-services-for-delegation/

The process concluded that a transitional year of joint commissioning would offer the most secure and stable transition towards delegation. There is a comprehensive programme structure in place to support the ICBs in the four regions that are working towards delegation in April 2025, to support them in being ready to take on the responsibilities. NHS England is continuing to work alongside ICBs to ensure that delegation agreements are in place, including ensuring appropriate collaborative arrangements are developed to support ICB commissioning of specialised services. These arrangements will be monitored by NHS England through its assurance processes for specialised services.

A webinar series for commissioning staff, including colleagues in ICBs, was delivered in 2023 across different aspects of specialised services, and there are additional webinars planned in 2024. There has been, and will continue to be, local engagement between regional commissioning teams and ICB teams, as the future operating model is co-developed. A suite of support materials has been shared with teams and continues to be updated. As examples, these include: Commissioning Change Management Business Rules; Finance and Accounting Standard Operating Procedure; and the Contracting Standard Operating Procedure.

NHS England develops services specification and clinical policies through its Clinical Reference Groups. There are 250 published service specifications which include clinical pathway, quality, and other relevant standards, which are specific to the clinical service. Regional commissioning teams, overseen by the statutory joint committees, are responsible for implementing the specifications in their commissioning of services, along with assessing compliance against national standards. NHS England has developed Specialised Services Quality Dashboards alongside service specifications, which provide additional data to monitor the quality of services.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment she has made of the potential impact of the nine statutory joint committees formed between integrated care boards and NHS England regions on specialised commissioning.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

The total spend on commissioning specialised services was £22.7 billion in 2022/23 and £25 billion in 2023/24. As formal delegation of specialised services to integrated care boards (ICBs) begins from 1 April 2024, all spend on commissioning these services in previous years has been the responsibility of NHS England, and not the ICBs. For 2024/25, NHS England is delegating £5.3 billion of commissioning resource to ICBs in the three regions, where delegation will begin from April 2024. This figure excludes high-cost drugs and devices spend.

The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between the ICBs and NHS England regional teams, followed by a National Moderation Panel, and final decision taken by the NHS England Board. The NHS England Board papers for February 2023, December 2023, and March 2024 are available, respectively, at the following links:

https://www.england.nhs.uk/wp-content/uploads/2023/02/board-2-feb-23-item-7-delegation-of-spec-comm.pdf

https://www.england.nhs.uk/long-read/specialised-commissioning-2024-25-next-steps-with-delegation-to-integrated-care-boards/

https://www.england.nhs.uk/long-read/specialised-commissioning-update-on-specialised-services-for-delegation/

The process concluded that a transitional year of joint commissioning would offer the most secure and stable transition towards delegation. There is a comprehensive programme structure in place to support the ICBs in the four regions that are working towards delegation in April 2025, to support them in being ready to take on the responsibilities. NHS England is continuing to work alongside ICBs to ensure that delegation agreements are in place, including ensuring appropriate collaborative arrangements are developed to support ICB commissioning of specialised services. These arrangements will be monitored by NHS England through its assurance processes for specialised services.

A webinar series for commissioning staff, including colleagues in ICBs, was delivered in 2023 across different aspects of specialised services, and there are additional webinars planned in 2024. There has been, and will continue to be, local engagement between regional commissioning teams and ICB teams, as the future operating model is co-developed. A suite of support materials has been shared with teams and continues to be updated. As examples, these include: Commissioning Change Management Business Rules; Finance and Accounting Standard Operating Procedure; and the Contracting Standard Operating Procedure.

NHS England develops services specification and clinical policies through its Clinical Reference Groups. There are 250 published service specifications which include clinical pathway, quality, and other relevant standards, which are specific to the clinical service. Regional commissioning teams, overseen by the statutory joint committees, are responsible for implementing the specifications in their commissioning of services, along with assessing compliance against national standards. NHS England has developed Specialised Services Quality Dashboards alongside service specifications, which provide additional data to monitor the quality of services.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many infrastructure failures at NHS trusts have been recorded in each of the last five years; and how many such failures had an impact on clinical service delivery in each of those years.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The National Health Service publishes the annual Estates Returns Information Collection, which includes detailed information on the NHS estate. Individual NHS Trusts are responsible for providing the data for the Estates Returns Information Collection and ensuring the accuracy of their returns. The information can be found at:

https://digital.nhs.uk/data-and-information/publications/statistical/estates-returns-information-collection

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps she is taking to ensure that integrated care boards take into account a) clinical, b) patient and c) provider experience when commissioning specialised services.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

NHS England's delegation agreement with the integrated care boards (ICBs) requires each ICB to establish effective, safe, efficient, and economic arrangements for the commissioning of delegated specialised services, with particular reference to statutory obligations relating to health and care bodies, such as the triple aim.

The delegation agreement supports these responsibilities, including following all relevant legislation, guidance, and good practice. In commissioning delegation specialised services, ICBs must: consider how they can meet their legal duties to involve patients and the public in shaping the provision of services; work with local communities, under-represented groups, and those with protected characteristics; consider how they can address health inequalities; assist in the development of national standards, including service specifications and clinical commissioning policies; support the development of local clinical leadership and expertise in respect of specialised services; support specialised clinical networks and clinical reference groups, including participating in development and agreement of the annual plan for relevant clinical networks; and work with providers as commissioners of specialised services, including management of contracts and the annual contracting round, financial management, and working with providers on identification and management of any issues relating to quality of services.

Appropriate oversight and assurance arrangements are in place to assure the commissioning capability and capacity of ICBs, and so that NHS England, as the accountable commissioner, has the right mechanisms where support or intervention is needed, regardless of whether a service is retained by NHS England or falls within scope of delegated commissioning arrangements.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether she has made an assessment of progress in the development of a clinical analytical service for specialised commissioning.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

Commissioners of Specialised Services have access to the analysis of clinical data via their regional business intelligence teams, or the nationally commissioned Commissioning Support Unit (CSU) service provision.

Routine reporting can be accessed via the National Commissioning Data Repository, and more focused analytics can be performed across commissioning and clinical datasets collected by NHS England. NHS England has developed 181 Specialised Services Quality Dashboards alongside service specifications, which provide additional data to monitor the quality of services and maintain clinical registries ranging from bowel cancer to pulmonary hypertension. The full list is available at the following link:

https://digital.nhs.uk/data-and-information/clinical-audits-and-registries

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to Annex A of the NHS publication entitled Specialised Commissioning – update on specialised services for delegation, published on 28 March 2024, whether she plans for the 32 specialised services retained by NHS England from April 2025 to be (a) delegated or (b) retained in perpetuity.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between integrated care boards (ICBs) and NHS England regional teams, followed by a National Moderation Panel and final decision taken by the NHS England Board. The NHS England Board papers for February 2023, December 2023, and March 2024 are available respectively at the following links:

https://www.england.nhs.uk/wp-content/uploads/2023/02/board-2-feb-23-item-7-delegation-of-spec-comm.pdf

https://www.england.nhs.uk/long-read/specialised-commissioning-2024-25-next-steps-with-delegation-to-integrated-care-boards/

https://www.england.nhs.uk/long-read/specialised-commissioning-update-on-specialised-services-for-delegation/

The process concluded that a transitional year of joint commissioning would offer the most secure and stable transition towards delegation. NHS England is working alongside ICBs to ensure that delegation agreements are in place, including ensuring appropriate collaborative arrangements are developed to support ICB commissioning of specialised services. These arrangements will be monitored by NHS England through its assurance processes for specialised services.

On 28 March 2024, the NHS England Board approved the recommendation that the 32 specialised services listed in Annex A of Item 7 of Specialised Commissioning: update on specialised services for delegation, would be retained by NHS England.

Regardless of delegation status, NHS England will remain the accountable commissioner for the entire portfolio of specialised services, and as part of this role, will monitor the effectiveness of delegation and the lists of services. It should be noted that NHS England does have the ability to bring a service back under national commissioning control, under the safeguards put in place to support delegation.

All specialised services, whether retained or delegated, must comply with nationally developed standards, including service specifications and clinical commissioning polices. ICBs will be able to use specialised services funding to transform and develop services and pathways across their core and specialised responsibilities, to improve quality of care and equity of access and value, whilst also complying with national standards.

Whilst delegation is not an end in itself, moving to ICB-led commissioning supports a focus on population health management across whole pathways of care, and gives ICBs the powers they need to improve the quality of services, tackle health inequalities, and ensure best value. NHS England set out in detail the benefits of greater ICB involvement in the commissioning of appropriate specialised services in the Roadmap for Integrating Specialised Services within Integrated Care Systems, and subsequent board papers. This roadmap is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2022/05/PAR1440-specialised-commissioning-roadmap-addendum-may-2022.pdf

These plans have been developed in close collaboration with NHS England’s regional teams, ICBs, specialised service providers, clinicians, and patients, and represent the outcome of a thorough assessment of ICB system readiness, and a comprehensive analysis of services to determine their suitability and readiness for more integrated commissioning. During 2024/25, specialised services commissioning teams will remain employed by NHS England. NHS England has a framework for commissioning support, and accesses a range of services from commissioning support units. For example, data and business intelligence, and programme and project management expertise and resources.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment she has made of the potential imapct of delegating specialised services to Integrated Care Systems on continuity of care for patients.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between integrated care boards (ICBs) and NHS England regional teams, followed by a National Moderation Panel and final decision taken by the NHS England Board. The NHS England Board papers for February 2023, December 2023, and March 2024 are available respectively at the following links:

https://www.england.nhs.uk/wp-content/uploads/2023/02/board-2-feb-23-item-7-delegation-of-spec-comm.pdf

https://www.england.nhs.uk/long-read/specialised-commissioning-2024-25-next-steps-with-delegation-to-integrated-care-boards/

https://www.england.nhs.uk/long-read/specialised-commissioning-update-on-specialised-services-for-delegation/

The process concluded that a transitional year of joint commissioning would offer the most secure and stable transition towards delegation. NHS England is working alongside ICBs to ensure that delegation agreements are in place, including ensuring appropriate collaborative arrangements are developed to support ICB commissioning of specialised services. These arrangements will be monitored by NHS England through its assurance processes for specialised services.

On 28 March 2024, the NHS England Board approved the recommendation that the 32 specialised services listed in Annex A of Item 7 of Specialised Commissioning: update on specialised services for delegation, would be retained by NHS England.

Regardless of delegation status, NHS England will remain the accountable commissioner for the entire portfolio of specialised services, and as part of this role, will monitor the effectiveness of delegation and the lists of services. It should be noted that NHS England does have the ability to bring a service back under national commissioning control, under the safeguards put in place to support delegation.

All specialised services, whether retained or delegated, must comply with nationally developed standards, including service specifications and clinical commissioning polices. ICBs will be able to use specialised services funding to transform and develop services and pathways across their core and specialised responsibilities, to improve quality of care and equity of access and value, whilst also complying with national standards.

Whilst delegation is not an end in itself, moving to ICB-led commissioning supports a focus on population health management across whole pathways of care, and gives ICBs the powers they need to improve the quality of services, tackle health inequalities, and ensure best value. NHS England set out in detail the benefits of greater ICB involvement in the commissioning of appropriate specialised services in the Roadmap for Integrating Specialised Services within Integrated Care Systems, and subsequent board papers. This roadmap is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2022/05/PAR1440-specialised-commissioning-roadmap-addendum-may-2022.pdf

These plans have been developed in close collaboration with NHS England’s regional teams, ICBs, specialised service providers, clinicians, and patients, and represent the outcome of a thorough assessment of ICB system readiness, and a comprehensive analysis of services to determine their suitability and readiness for more integrated commissioning. During 2024/25, specialised services commissioning teams will remain employed by NHS England. NHS England has a framework for commissioning support, and accesses a range of services from commissioning support units. For example, data and business intelligence, and programme and project management expertise and resources.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment she has made of the potential impact of delegating specialised services to Integrated Care Systems on patient outcomes.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between integrated care boards (ICBs) and NHS England regional teams, followed by a National Moderation Panel and final decision taken by the NHS England Board. The NHS England Board papers for February 2023, December 2023, and March 2024 are available respectively at the following links:

https://www.england.nhs.uk/wp-content/uploads/2023/02/board-2-feb-23-item-7-delegation-of-spec-comm.pdf

https://www.england.nhs.uk/long-read/specialised-commissioning-2024-25-next-steps-with-delegation-to-integrated-care-boards/

https://www.england.nhs.uk/long-read/specialised-commissioning-update-on-specialised-services-for-delegation/

The process concluded that a transitional year of joint commissioning would offer the most secure and stable transition towards delegation. NHS England is working alongside ICBs to ensure that delegation agreements are in place, including ensuring appropriate collaborative arrangements are developed to support ICB commissioning of specialised services. These arrangements will be monitored by NHS England through its assurance processes for specialised services.

On 28 March 2024, the NHS England Board approved the recommendation that the 32 specialised services listed in Annex A of Item 7 of Specialised Commissioning: update on specialised services for delegation, would be retained by NHS England.

Regardless of delegation status, NHS England will remain the accountable commissioner for the entire portfolio of specialised services, and as part of this role, will monitor the effectiveness of delegation and the lists of services. It should be noted that NHS England does have the ability to bring a service back under national commissioning control, under the safeguards put in place to support delegation.

All specialised services, whether retained or delegated, must comply with nationally developed standards, including service specifications and clinical commissioning polices. ICBs will be able to use specialised services funding to transform and develop services and pathways across their core and specialised responsibilities, to improve quality of care and equity of access and value, whilst also complying with national standards.

Whilst delegation is not an end in itself, moving to ICB-led commissioning supports a focus on population health management across whole pathways of care, and gives ICBs the powers they need to improve the quality of services, tackle health inequalities, and ensure best value. NHS England set out in detail the benefits of greater ICB involvement in the commissioning of appropriate specialised services in the Roadmap for Integrating Specialised Services within Integrated Care Systems, and subsequent board papers. This roadmap is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2022/05/PAR1440-specialised-commissioning-roadmap-addendum-may-2022.pdf

These plans have been developed in close collaboration with NHS England’s regional teams, ICBs, specialised service providers, clinicians, and patients, and represent the outcome of a thorough assessment of ICB system readiness, and a comprehensive analysis of services to determine their suitability and readiness for more integrated commissioning. During 2024/25, specialised services commissioning teams will remain employed by NHS England. NHS England has a framework for commissioning support, and accesses a range of services from commissioning support units. For example, data and business intelligence, and programme and project management expertise and resources.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment she has made of the potential impact of joint commissioning on the 59 specialised services approved by the NHS England Board in February 2023.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between integrated care boards (ICBs) and NHS England regional teams, followed by a National Moderation Panel and final decision taken by the NHS England Board. The NHS England Board papers for February 2023, December 2023, and March 2024 are available respectively at the following links:

https://www.england.nhs.uk/wp-content/uploads/2023/02/board-2-feb-23-item-7-delegation-of-spec-comm.pdf

https://www.england.nhs.uk/long-read/specialised-commissioning-2024-25-next-steps-with-delegation-to-integrated-care-boards/

https://www.england.nhs.uk/long-read/specialised-commissioning-update-on-specialised-services-for-delegation/

The process concluded that a transitional year of joint commissioning would offer the most secure and stable transition towards delegation. NHS England is working alongside ICBs to ensure that delegation agreements are in place, including ensuring appropriate collaborative arrangements are developed to support ICB commissioning of specialised services. These arrangements will be monitored by NHS England through its assurance processes for specialised services.

On 28 March 2024, the NHS England Board approved the recommendation that the 32 specialised services listed in Annex A of Item 7 of Specialised Commissioning: update on specialised services for delegation, would be retained by NHS England.

Regardless of delegation status, NHS England will remain the accountable commissioner for the entire portfolio of specialised services, and as part of this role, will monitor the effectiveness of delegation and the lists of services. It should be noted that NHS England does have the ability to bring a service back under national commissioning control, under the safeguards put in place to support delegation.

All specialised services, whether retained or delegated, must comply with nationally developed standards, including service specifications and clinical commissioning polices. ICBs will be able to use specialised services funding to transform and develop services and pathways across their core and specialised responsibilities, to improve quality of care and equity of access and value, whilst also complying with national standards.

Whilst delegation is not an end in itself, moving to ICB-led commissioning supports a focus on population health management across whole pathways of care, and gives ICBs the powers they need to improve the quality of services, tackle health inequalities, and ensure best value. NHS England set out in detail the benefits of greater ICB involvement in the commissioning of appropriate specialised services in the Roadmap for Integrating Specialised Services within Integrated Care Systems, and subsequent board papers. This roadmap is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2022/05/PAR1440-specialised-commissioning-roadmap-addendum-may-2022.pdf

These plans have been developed in close collaboration with NHS England’s regional teams, ICBs, specialised service providers, clinicians, and patients, and represent the outcome of a thorough assessment of ICB system readiness, and a comprehensive analysis of services to determine their suitability and readiness for more integrated commissioning. During 2024/25, specialised services commissioning teams will remain employed by NHS England. NHS England has a framework for commissioning support, and accesses a range of services from commissioning support units. For example, data and business intelligence, and programme and project management expertise and resources.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what engagement commissioning hub teams looking at specialised commissioning have with commissioning support units.

Answered by Helen Whately - Minister of State (Department of Health and Social Care)

The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between integrated care boards (ICBs) and NHS England regional teams, followed by a National Moderation Panel and final decision taken by the NHS England Board. The NHS England Board papers for February 2023, December 2023, and March 2024 are available respectively at the following links:

https://www.england.nhs.uk/wp-content/uploads/2023/02/board-2-feb-23-item-7-delegation-of-spec-comm.pdf

https://www.england.nhs.uk/long-read/specialised-commissioning-2024-25-next-steps-with-delegation-to-integrated-care-boards/

https://www.england.nhs.uk/long-read/specialised-commissioning-update-on-specialised-services-for-delegation/

The process concluded that a transitional year of joint commissioning would offer the most secure and stable transition towards delegation. NHS England is working alongside ICBs to ensure that delegation agreements are in place, including ensuring appropriate collaborative arrangements are developed to support ICB commissioning of specialised services. These arrangements will be monitored by NHS England through its assurance processes for specialised services.

On 28 March 2024, the NHS England Board approved the recommendation that the 32 specialised services listed in Annex A of Item 7 of Specialised Commissioning: update on specialised services for delegation, would be retained by NHS England.

Regardless of delegation status, NHS England will remain the accountable commissioner for the entire portfolio of specialised services, and as part of this role, will monitor the effectiveness of delegation and the lists of services. It should be noted that NHS England does have the ability to bring a service back under national commissioning control, under the safeguards put in place to support delegation.

All specialised services, whether retained or delegated, must comply with nationally developed standards, including service specifications and clinical commissioning polices. ICBs will be able to use specialised services funding to transform and develop services and pathways across their core and specialised responsibilities, to improve quality of care and equity of access and value, whilst also complying with national standards.

Whilst delegation is not an end in itself, moving to ICB-led commissioning supports a focus on population health management across whole pathways of care, and gives ICBs the powers they need to improve the quality of services, tackle health inequalities, and ensure best value. NHS England set out in detail the benefits of greater ICB involvement in the commissioning of appropriate specialised services in the Roadmap for Integrating Specialised Services within Integrated Care Systems, and subsequent board papers. This roadmap is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2022/05/PAR1440-specialised-commissioning-roadmap-addendum-may-2022.pdf

These plans have been developed in close collaboration with NHS England’s regional teams, ICBs, specialised service providers, clinicians, and patients, and represent the outcome of a thorough assessment of ICB system readiness, and a comprehensive analysis of services to determine their suitability and readiness for more integrated commissioning. During 2024/25, specialised services commissioning teams will remain employed by NHS England. NHS England has a framework for commissioning support, and accesses a range of services from commissioning support units. For example, data and business intelligence, and programme and project management expertise and resources.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what the annual running costs were for NHS (a) Arden and GEM, (b) Midlands and Lancashire, (c) North of England and (d) South, Central and West Commissioning Support Unit in the 2022-23 financial year.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The Department does not hold the information requested. Commissioning Support Units (CSUs) form part of one service provided to Clinical Commissioning Groups and integrated care boards by NHS England. CSUs are not separate legal entities, and spending forms part of NHS England’s parent accounts.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how much each NHS Integrated Care Systems owed to NHS England for historic deficits at the end of the 2023-24 financial year.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The final year-end financial position for the integrated care boards, National Health Service trusts, and foundation trusts has not yet been finalised. All figures are due to be audited and will be reported in the accounts for all organisations, as well as in the Department’s 2023/24 Annual Report and Accounts, to be published later this year.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many NHS (a) integrated care systems and (b) trusts were in deficit at the end of the 2023-24 financial year; and if she will publish a breakdown of those figures by (i) acute, (ii) mental health, (iii) community health, (iv) ambulance services and (v) other types of trust.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The final year-end financial position for the integrated care boards, National Health Service trusts, and foundation trusts has not yet been finalised. All figures are due to be audited and will be reported in the accounts for all organisations, as well as in the Department’s 2023/24 Annual Report and Accounts, to be published later this year.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what the overall year end deficit for integrated care systems was in the financial year 2023-24.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The final year-end financial position for the integrated care boards, National Health Service trusts, and foundation trusts has not yet been finalised. All figures are due to be audited and will be reported in the accounts for all organisations, as well as in the Department’s 2023/24 Annual Report and Accounts, to be published later this year.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, in how many NHS trusts temporary buildings are in use.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The National Health Service does not hold data on the number of temporary buildings in use.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many IT failures there have been at NHS trusts that affected clinical service delivery in each of the last five years.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The information requested is not held centrally.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many IT failures there have been at NHS trusts in each of the last five years.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The information requested is not held centrally.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many and what proportion of (a) CT and (b) MRI scanners have been in operation for longer than 10 years.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

It has not proved possible to respond to the hon. Member in the time available before Dissolution.

Found: Randall MP (Conservative, Gedling ) Lloyd Russell-Moyle MP (Labour (Co-op), Brighton, Kemptown ) Karin

Found: Randall MP (Conservative, Gedling ) Lloyd Russell-Moyle MP (Labour (Co-op), Brighton, Kemptown ) Karin