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New health reform guidance vague over councils' support role

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New draft guidance on commissioning support for health services under the government’s NHS reforms suggests a greater centralisation of some functions currently undertaken at a local level.

Towards Commissioning Excellence refers to a potential role for councils, but mainly advises them to monitor local developments to see what additional support they can offer, as well as ensuring effective public health input.

The document, seen by LGC’s sister title Health Service Journal, encourages councils to “work to understand the separation of commissioning decisions about populations and the support functions that enable those decisions to happen” as a basis for considering how their services can fit in with potential commissioning support suppliers.

Councils are also encouraged to think about their “role in the joint commissioning agenda” and how they can work with commissioners and NHS commissioning support to add value.

The final piece of advice to councils is to work with health service commissioners to ensure “effective public health input into the shared health and wellbeing agenda”.

This advice stands in stark contrast to that offered to the independent and third sectors, which are more directly encouraged to develop offerings “based on their assessment of market need”.

Health reporting HSJ and LGC logo

Elsewhere, the guidance proposes a more centralised approach to “business intelligence” such as collecting and organising data, “major clinical procurement”, and back-office functions such as IT, estates management, human resources and finance and communications.

The document, circulated to primary care trust cluster leaders, cites “evidence” of the efficiency of a “national approach” to these services.

Earlier this year, Blackburn with Darwen BC expressed concerns that a more nationally driven focus on communications could result in extra burdens being placed on local authorities.

The council, which currently has an integrated communications team as part of its Care Trust Plus model, was keen to maintain a locally focused service.

Elsewhere, the draft guidance suggests that some functions - such as aspects of business intelligence -would be best performed at a sub-national level. It suggests area sizes of roughly five million residents - not dissimilar to current sizes for strategic health authorities or the abolished government regional offices.

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