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New statutory guidance for commissioners

In April NHS England published refreshed statutory guidance on the legal duties of CCGs with respect to involving people in commissioning and involving people in their own health and care. Commissioning teams will need to have regard to both sets of guidance, which can be found on NHS England's website   

1)      Patient and public participation in commissioning health and care

The legal duties of CCGs to involve people in commissioning activity are set out in the section 14Z2 of the Health and Social Care Act 2012.  This replaces the previous guidance 'Transforming Participation in Health and Care' and applies to clinical commissioning groups and to NHS England. It sets out ten key actions to embed involvement in our work:

  • Involve the public in governance
  • Explain public involvement in commissioning plans
  • Demonstrate public involvement in annual reports
  • Promote and publicise public involvement
  • Assess, plan and take action to involve
  • Feed back and evaluate
  • Implement assurance and improvement systems
  • Advance equality and reduce health inequalities
  • Provide support for effective involvement
  • Hold providers to account 
The guidance acknowledges the complexities of commissioning in a changing healthcare landscape, providing clarity and links to good practice examples, resources and advice to support CCGs in areas of our work with partners including Sustainability and Transformation Partnerships, devolution, joint commissioning arrangements and the delegation of primary care to CCGs. A step-by-step guide supports commissioners to assess whether and how they will need to involve patients, the public and voluntary and community sector groups and Healthwatch, and also highlights important considerations such as proportionality and timing.           

2)      Involving people in their own health and care

Legal duties of CCGs to involve people in their own health and care are set out in the section 14U of the Health and Social Care Act 2012.  The guidance is not prescriptive but sets out a clear expectation that CCGs will adhere to the principle of shared decision-making – no decision about me without me' in their activity.  In terms of what CCGs should do in practice, the following ten areas are listed:

  • Support patients, carers and representatives
  • Publicise and promote personal heath budgets
  • Publicise and promote the choices available to patients
  • Commission for involvement
  • Promote and publicise the involvement of individuals
  • Assure themselves that providers are involving people in their own health a care to an acceptable standard
  • Use and promote tools and resources
  • Assure themselves that they are commissioning services that match the needs and preferences of their population implement workforce strategy to support health and care professionals to involve people in their own heath and care
  • Advance equality and reduce health inequalities

The guidance points to opportunities for promoting individuals' involvement in care planning, shared decision-making and personal health budgets and points to approaches including peer support, social prescribing and PAMs alongside digital developments as instrumental to progressing this agenda.

Both sets of guidance can be found on NHS England's website.