NHS England is an executive non-departmental public body of the Department of Health.
NHS England oversees the budget, planning, delivery and day-to-day operation of the commissioning side of the NHS in England as set out in the Health and Social Care Act 2012. It holds the contracts for GPs and NHS dentists.
NHS England comprises around 6, 500 staff in 50 sites around England. The bulk of its staff previously worked for the decommissioned primary care trusts and strategic health authorities.
NHS England is the operating name of the NHS Commissioning Board and, before that, the NHS Commissioning Board Authority. It was set up as a special health authority of the NHS in October 2011 as the forerunner to becoming an NDPB on 1 April 2013. It was renamed NHS England on 26 March 2013. Its legal name remains the NHS Commissioning Board.
Sir David Nicholson who became Chief Executive at the establishment of the Board retired at the end of March 2014 and was replaced by Simon Stevens. One of Stevens' first acts was to announce a restructure of its 27 area teams in response to a requirement to reduce running costs which would reduce staffing by around 500. The 27 teams outside London are to be reduced to 12 in 2015.
NHS England in conjunction with the other central regulators established what is called a "success regime" in south and mid Essex, North Cumbria and north east and western Devon in June 2015. It is intended to tackle “deep rooted and systemic issues that previous interventions have not tackled across [a] whole health and care economy”.
Applications by GPs to reduce their catchment area are dealt with by NHS England. Requests to reduce the number of patients eligible to join a practice and in some cases also to deregister existing patients, have risen with 26 made between April and October 2014 compared to 30 for the whole of 2013/14. Only 15 have been approved.
In November 2014 Mr Justice Popplewell declared that NHS England “has acted unlawfully by reason of its failure to make arrangements for the involvement of patients in primary care commissioning decisions as required by the National Health Service Act 2006”. The case involved the decision to scrap minimum practice income guarantee. Richard Stein, a partner at Leigh Day, said the declaration could mean that patients would have to be involved in discussions on changes to the GP contract.
NHS England awarded a 4-year contract to Capita to become sole provider of administrative services including payment administration, management of medical records, and eligibility lists for practitioners for GPs, opticians and dentists across the UK in June 2015.
The organisation was reported to be developing a strategy to support the use of personal health records in June 2015. This, it is hoped, could achieve up to £3.4 billion in annual efficiency savings by 2020.
It has been criticised for delays in deciding on a policy for the prescription of Everolimus in the treatment of tuberous sclerosis. Twenty doctors addressed a letter to the board in support of the charity Tuberous Sclerosis Association saying "around 32 patients with critical need, whose doctors believe everolimus treatment is their best or only option, have no hope of access to funding. Most have been waiting many months. Approximately half of these patients are at imminent risk of a catastrophic event (renal bleed or kidney failure) with a high risk of preventable death." In May 2015 it was reported that Luke Henry and Stephanie Rudwick, the parents of a child suffering from Tuberous Sclerosis were trying to sell their home in Brighton to raise the money to pay for treatment for their daughter Bethany who has tumours on her brain, kidneys and liver and suffers from up to fifty epileptic fits a day.
The organisation's responsibilities include arbitration in disputes between clinical commissioning groups and NHS trusts.
Funding of Clinical Commissioning Groups
NHS England allocates funding (of £69.5 billion in 2016/7) to CCGs in accordance with a funding formula. Until 2016 progress towards the amount indicated by the formula from the historical allocation was very slow, and CCGs which were above their allocation did not actually suffer a reduction. From April 2016 however CCGs with more than 10% above their fair share will receive "flat cash" - an effective reduction. This will also ensure than no CCG is more than 5% below its target allocation in 2016/7.