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'Essential services key to protecting patients'

'Essential services key to protecting patients'


Exclusive Commissioners that fail to nominate essential services may not be “doing their jobs” properly, one of Monitor’s directors has claimed. 

Healthcare sector regulator Monitor will insure services in case of financial failure, to ensure continuity of services for patients. 

However, NHS England area teams, specialised commissioners, clinical commissioning groups (CCGs) and commissioning support units will only be helped if they let Monitor know which essential services must be guaranteed. 

Speaking exclusively to The Commissioning Review, Jason Dorsett, director of finance, reporting and risk said that there has been a lot of interest in the scheme with “good levels of engagement” to date. 

But he did note that some commissioners are not “brilliantly engaged”. 

He said: “We will have the ability to target people who don’t seem to be engaged. We know which CCGs have gone to our workshops, we know which CCGs are signed up to our mailing lists and we know [the CCGs] who don’t appear anywhere.” 

Commissioners that have not started the process over the next few months may receive a letter suggesting they “consider designation”, Dorsett (pictured) said. 

Late last year it was revealed that commissioners can choose an unlimited number of services to designate as ‘commissioner requested services’ (CRS). The application process opened last moth, and can take up to four months to complete. 

Dorsett believes the CRS process is another “big responsibility” for commissioners to take on. 

“You’ve got to make sure that the providers you buy healthcare from are going to be around to deliver that healthcare,” he said. 


“One of the ways you do that is through due diligence, but another way is to figure out what is really essential and to avail yourself of the extra regulation that the law has given you to protect you and your patients. 

“[Commissioners] are busy people, but I think that they would not be completely doing their jobs if they hadn’t made sure that the services they are commissioning for the public are secure.” 

Designating services is an “added layer of protection” for commissioners, Dorsett said. 

He said: “If there would be major health impacts from them not being there, then they are an essential part of the fabric of NHS provision, and we need to have arrangements in place to make sure that patients don’t suffer.” 

A newly enshrined Monitor function will see the regulator begin to license independent providers. Eligible providers have to apply by the end of March, in order to be fully licensed by 1 April. 

This new function will mean that independent providers are subject to the same financial scrutiny as NHS providers. 

The providers will have to show business plans and other potentially sensitive information to Monitor, which will be used to decide whether the organisation is financially viable. 

Although CCGs and other commissioners will not have direct access to the reports created, independent providers that are having financial issues will be flagged on the Monitor website.

“This will provide [commissioners] with a regulatory oversight, which should give them confidence to focus their time on the mainstays of commissioning – the quality of the service and delivery to patients,” said Dorsett. 

He added: “We will see what additional briefing commissioners might like [later]. We’re not going to be publishing financial reports, but we will be doing the regulation, which CCGs will be able to take comfort from.”  

The regulator is set to release final details of the consultation into licensing of private providers and commissioner requested services over the next few weeks. 


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