Last updated – 27 April 2016
The NAO carried out a Value for Money review of the commissioning of specialised services by NHS England (NHSE) between September 2015 and April 2016. To inform our review, we conducted two web-based surveys between December 2015 and February 2016, of (1) all acute and specialist trusts (Providers) in England, and (2) all clinical commissioning groups (CCGs) in England.
Both surveys sought providers’/clinical commissioning groups’ views and experiences on a range of issues, including the current scope of specialised services, NHSE’s strategy for specialised commissioning, its communication of that strategy, its capacity and governance arrangements and the impact of specialised commissioning on patient care. For the provider survey, we also asked questions on contracting arrangements, performance reporting, and tariff and reimbursement arrangements for specialised services. For the survey of clinical commissioning groups, we also sought their views on the development of collaborative commissioning.
Of the 154 acute and specialist trusts surveyed (excluding mental health and those trusts with no contract with NHS England for specialised services), 68 responded to our survey, a response rate of 44%. Of the 209 clinical commissioning groups surveyed, 76 responded to our survey, a response rate of 36%.
In reporting the survey results for acute and specialist trusts (providers), we used the following classifications:
- Provider tiers: Providers were divided into 4 tiers depending on their income from specialised services. The threshold values for Tiers 1, 2 and 3 are £190m, £50m and £15m respectively. Tier 4 providers have an income of less than £15 million from specialised services.
- Provider types: Trusts we surveyed included large, medium and small acute district general hospital trusts, acute specialist hospital trusts and acute teaching hospital trusts as classified by the NHS. The size of a trust is based on their number of beds. Specialist acute trusts are regional or national centres providing specialised care, and teaching trusts are attached to universities and help to train health professionals.
The numbering of the survey questions in this presentation match those in the original surveys sent out. Some questions have been excluded because information was either not relevant (for example, contact details) or the data was incomplete. As a result, the first question in both visualisations is number 2 and certain question numbers are not presented (for example, question 12 of the providers’ survey).
Questions where no response was received have been excluded from the results. Percentages shown in the presentation are therefore calculated as a proportion of respondents answering the specific question or sub-question rather than the total number of surveys returned.