NHS England has told commissioners to suspend all GP out of hours and NHS 111 procurements while it draws up new rules for creating ‘functionally integrated’ urgent care services, HSJ has learned.
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A letter from commissioning operations director Dame Barbara Hakin said clinical commissioning groups should suspend the procurements, regardless of the stage reached until September.
The moratorium has been called to give the national body time to draw up a set of commissioning standards and a clinical model for what is described as a “functionally integrated urgent care access, treatment and clinical advice service”.
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These new services will join up 24/7 urgent care access with treatment and advice, and incorporate current NHS 111 and out of hours provision, according to the letter, which was sent to CCGs and 111 providers on Friday.
At present these services are often procured separately and across areas of various different sizes.
Dame Barbara wrote: “Further procurements of NHS 111 and OOH services should be suspended, whatever stage of the procurement has been reached, until the end of September, to allow completion of the consultation and the release of the revised commissioning standards and supporting procurement advice for integrated services.”
The letter, seen by HSJ, marks the start of a consultation exercise.
The letter also indicates NHS England believes commissioners should group together to plan and contract 111 and out of hours services across larger areas, potentially as large as the emerging “urgent and emergency care networks”.
It said: “The lead or coordinating commissioner arrangement should be considered, in which commissioners serving a wider area are brought together to commission an integrated service.
“This has been shown in a number of areas to be an effective model for engaging with providers, particularly those that deliver services over an area covering a number of clinical commissioning groups, and to effect strategic change.”
It states that the ongoing NHS England urgent and emergency care review “envisages that an area covered by an urgent and emergency care network will, in most cases, be the most appropriate level for agreeing how a service… should be commissioned”.
Dame Barbara’s letter also said commissioners should consider moving to a “lead provider arrangement” for contracting the services, or “using the procurement process [in other ways] to encourage NHS 111 and OOH organisations to collaborate”. However, it clarified that NHS England had “no expectation” that any organisations should merge.