Nurse

The History of Clinical Commissioning in the NHS

By mck890

  • NHS Community Care Act 1990

    NHS Community Care Act 1990
    Health authorities will now manage their own budgets and buy health care from hospitals and other health organisations. In order to be deemed a 'provider' of such health care, organisations will become NHS trusts – independent organisations with their own management.

  • First NHS Trusts Eastablished

    First NHS Trusts Eastablished
    57 new NHS trusts were set up with the aim of encouraging creativity and innovation and challenging the domination of hospitals within a health service increasingly focused on services in the community.

  • 2 models of commissioning are created

    2 models of commissioning are created
    Following the NHS and Community Care Act 1990, local health authorities were no longer responsible for both the planning and delivery of services to patients. In 1991 commissioning became a discreet function, with 'purchasers' and 'providers', allowing local health authorities to contract out services. Two models of commissioning were created, one for health authorities and the other for general practice.

  • The Introduction of GP fundholding

    The Introduction of GP fundholding
    The general practitioner (GP) fundholding scheme was introduced by the conservative government in 1991 as part of wider NHS reforms.
    GPs could voluntarily elect to have greater control over their budgets and keep their savings. By 1997, 50% of GPs were fundholders covering around 60% of the population. The aim was to give GPs a financial incentive to manage costs and apply competitive pressure on hospital providers.
    The scheme was abolised by the Labour government in 1997.

  • The Total Purchasing Pilot (TPP) scheme 1994-97

    The Total Purchasing Pilot (TPP) scheme 1994-97
    The Total Purchasing Pilot (TPP) scheme allowed general practices, either together or in groups, to commission all services for their patients, though most were cautious in what they chose to purchase. TPPs acted as sub-committees to health authorities and used an indicative, rather than real budget. The pilot scheme ended in 1997.

  • GP fundholding abolished

    GP fundholding abolished
    GP fundholding was abolished by the Labour goverment in 1997, but the purchaser/provider commisioning split was retained. Health Authorities (HAs) were replaced by Primary Care Groups (PCGs) and then by Primary Care Trusts (PCTs).

  • Primary Care Trusts (PCTs) Launched

    Primary Care Trusts (PCTs) Launched
    152 Primary Care Trusts (PCTs) control 80% of the total NHS budget (amounting to £80 billion in 2009/10). They liaise with the private sector when contracting out services. As local organisations, they understand the needs of their community, so can ensure that organisations providing health and social care services work effectively.
    PCT's were abolished on April 1 2013 and most of their responsibilities handed to new clinical commissioning groups (CCGs).

  • Practice-Based Commissioning (PBC)

    Practice-Based Commissioning (PBC)
    A new form of GP commissioning was announced in 2004, practice-based commissioning (PBC). PBC was not compulsory, practices could chose to participate and were given an indicative budget by their Primary Care Trust (PCT) along with data on the volume of services their patients used. GPs were allowed to put an agreed share of efficiency savings into developing new services.

  • First Foundation Trusts created

    First Foundation Trusts created
    NHS foundation trusts, first introduced in April 2004, differ from other existing NHS trusts. They are independent legal entities and have unique governance arrangements. They are accountable to local people, who can become members and governors.
    They are set free from central government control and are no-longer performance managed by health authorities. As self-standing, self-governing organisations, NHS foundation trusts are free to determine their own future.

  • Care Quality Commission launched

    Care Quality Commission launched
    The Care Quality Commission (CQC) was launched in April 2009 as a new regulator for health, mental health and adult social care.
    The new organisation aims to help regulate the quality of services. It brings together information from the monitoring and inspection of all health and social care services

  • The Mid Staffordshire NHS Foundation Trust public inquiry

    The Mid Staffordshire NHS Foundation Trust public inquiry
    The Mid Staffordshire inquiry followed a report by the Healthcare Commission (now the Care Quality Commission) in March 2009. The investigation addressed the high mortality rates of patients admitted as emergencies to Mid Staffordshire NHS Foundation Trust since April 2005.
    Secretary of State for Health, Andrew Lansley MP, announced a full public inquiry into the role of commissioning, supervisory and regulatory bodies in the monitoring of the Mid Staffordshire Foundation NHS Trust.

  • The NHS White Paper

    The NHS White Paper
    Read the NHS White Paper here. The White Paper set out proposals for the future of the NHS - including plans to make it more efficient. Increasing patient focus, and empowering clinicians to lead innovation in improving healthcare services.

  • First draft of The Health and Social Care Bill 2012

    First draft of The Health and Social Care Bill 2012
    Read the Health and Social Care Act 2012 here. The Health and Social Care Bill was published in draft form on January 19 2011. The Bill takes forward the Equity and Excellence: Liberating the NHS white paper (July 2010) and is a crucial part of the government’s vision to modernise the NHS so that it is centred around patients,

  • The Health and Social Care Act 2012

    The Health and Social Care Act 2012
    The Health and Social Care Act 2012 was first published on June 15 2012 and took effect on April 1 2013. The Act brought in the most wide-ranging reforms of the NHS since it was founded in 1948.
    It puts clinicians at the centre of commissioning, frees up providers to innovate, empowers patients, and gives a new focus to public health. The Act covers the following themes: strengthening the commissioning of NHS services
    increasing democratic accountability and strengthening public health services.

  • FInal Report into the Mid Staffordshire NHS Foundation Turst public inquiry published

    FInal Report into the Mid Staffordshire NHS Foundation Turst public inquiry published
    Read a summary of key recommendations from the report Robert Francis QC published his final report on February 6 2013. It highlights a whole system failure, and not just one NHS trust. A system which should have had checks and balances in place, and have been working to ensure patients were treated with dignity and suffered no harm.The 1,782 page report has 290 recommendation which have major implications for all levels of the health service across England. This includes a more patient centred approach, better medical training and nursing.

  • PCTs abolished, CCGs introduced

    PCTs abolished, CCGs introduced
    Primary Care Trusts were abolished on 31 March 2013 as part of the Health and Social Care Act 2012, with their most of their commissioning work taken over by Clinical Commissioning Groups.(CCGs).

  • The new NHS

    The new NHS
    The NHS is undergoing major changes in its core structure. The new health and care system became operational on April 1 2013. It delivers the aims set out in the Health and Social Care Act. Public Health England, the NHS Trust Development Authority and Health Education England took on their responsibilities at the same time. Locally, clinical commissioning groups, made up of doctors, nurses and other health professionals, buy services for patients, while local councils promote public health.