NHS England is taking on extensive powers — normally held by clinical commissioning groups — to buy services from the private sector and to support the coronavirus effort as [it] “deems appropriate”.
In a national directive published today, the Department of Health and Social Care says the covid-19 crisis is “an emergency”, and it has legally directed NHSE to exercise key functions normally held by CCGs.
The directions have immediate effect and will be in place until the end of 2020. CCGs themselves continue to also hold the powers and functions.
The move appears principally to be to allow NHSE to buy independent sector beds on block, as announced in recent days. But the directive will also allow NHSE to exercise other CCG functions to support the covid-19 effort.
The directive says: “The secretary of state for health and social are gives the following directions in exercise of the powers conferred by section 253 of the National Health Service Act 2006(1).
“The secretary of state considers that the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in England constitutes an emergency for the purposes of section 253(1) of that Act, and that accordingly it is appropriate to give these directions.”
It adds that the functions ”must be exercised [by NHSE] for the purposes of commissioning health services from independent providers” and “as the board deems appropriate, for the purposes of directly or indirectly supporting the provision of services by NHS bodies to address coronavirus and coronavirus disease”.
The directions also allow NHSE to take over any function of a CCG as it “deems appropriate for the purpose of directly or indirectly supporting the provision of services by NHS bodies to address coronavirus and coronavirus disease”.
A note on the DHSC website says:”These directions enable NHS England to commission healthcare from independent sector providers to support the provision of services by the NHS to address the coronavirus (COVID-19) emergency.”
HSJ has heard a number of trust leaders over the last week expressing frustration at a perceived lack of support in getting patients discharged from hospitals, as well as financial concerns. However, it is not clear whether the directive is in part a response to those types of concerns.
Department of Health and Social Care document
March 23 2020