NHS England has established a turnaround team to get a grip on the spiralling specialised commissioning budget, HSJ has learned.

The team will be led by Paul Watson, NHS England regional director for the Midlands and East, for an initial period of three months. Alongside his regional role Dr Watson, also chaired NHS England’s specialised commissioning oversight group during 2013-14.

HSJ understands the team will tackle seven key areas, including one which aims to take a more rigorous approach to realising £800m savings, sought thought its quality, innovation, productivity and prevention programme.

Paul Watson

Paul Watson will lead the specialised commissioning turnaround team

Another will focus on ending variations in prices charged by providers for non-tariff specialised work.

The news follows last week’s HSJ report that NHS England was on course for an overspend of at least £450m on its £12.7bn planned spending during 2013-14.

The body had forecast overspends at two thirds of its biggest providers of acute and mental health specialised services.

Concern about the size of the specialised commissioning overspend has been growing in NHS England and is believed to be a key priority of new chief executive Simon Stevens, who is due to appear before the Commons health committee on Tuesday.

HSJ understands a recent stocktake of the information exchanged data between providers and the 10 NHS England area teams tasked with administering specialised commissioning contract has discovered that processes for validating provider invoices were weak and varied between areas.

This has led to concern invoices could have been paid out incorrectly; a key focus of the turnaround team will be standardising these processes across the country.  

During 2013-14 more than £600m was transferred from clinical commissioning group budgets to NHS England after it was found activity had been wrongly categorised as non-specialised, which CCGs are responsible for commissioning.

HSJ understands that NHS England’s desire to give CCGs stability means it will not be another large scale transfer. A small number of CCGs may, however, see further transfers from their budget to specialised commissioning where new misallocations of activity are discovered.

In a statement Dr Watson, who is a qualified doctor and public health consultant, said: “Given the current issues in specialised commissioning, we are setting up an internal team to make immediate improvements in how we commission these services.

“This will comprise seven distinct work streams with a particular focus on financial control in 2014-15 and planning for the 2015-16 commissioning round. I am looking forward to leading this piece of work and working with colleagues on taking this forward.”

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