Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, how decisions on the Commissioning through Evaluation process will be communicated to (a) patients, (b) hospital trusts and clinical commissioning groups and (c) the life sciences sector.

When Commissioning through Evaluation (CtE schemes) are agreed for implementation, a steering group is established which includes clinicians, patients and patient representatives, and the National Institute for Health and Care Excellence.

New schemes are publicised through NHS England’s website, through national Clinical Reference Groups to National Health Service providers, and to potentially eligible patients through discussions during routine NHS clinical care.

NHS England also ensures that interested manufacturers and / or pharmaceutical companies are kept informed of the progress of schemes.

In addition to national briefings, NHS England's local commissioning teams regularly liaise with clinical commissioning group colleagues on pathways of care where CtE schemes could be potentially introduced.

CtE schemes typically aim to deliver new data for treatments that are currently not routinely commissioned by the NHS, due to a lack of sufficient evidence of relative clinical and cost effectiveness.

The length of the analysis phase will depend on the follow up measures agreed at the start of the scheme. Once the scheme has completed the ‘recruitment’ phase, no new patients will receive the treatment concerned within the NHS unless or until there is a decision to adopt and publish a revised national clinical commissioning policy.

However, patients who consent to be part of a CtE scheme, and who consequently receive treatment during the time limited ‘recruitment’ phase, will continue to receive appropriate follow up clinical care within the NHS.

With regard to the retention of skills, a separate impact assessment process is not undertaken at the point at which the time limited recruitment phase for each CtE scheme comes to a planned close.

Instead, an impact assessment forms part of NHS England’s standard process when considering either the routine commissioning or decommissioning of a specialised service. The impact assessment (which covers the estimated impact on patients, providers and on cost and activity) forms part of the suite of documents that are consulted upon publicly as part of the development process for new or revised clinical commissioning policies. In addition, a commissioning plan is developed (including any aspects required to enable the successful implementation of a newly commissioned service, such as additional specialist training) for those policies that are ultimately recommended for funding and adoption.