Review proposed over London ambulance service control

Clinical commissioning groups in the capital could lose their responsibility for commissioning the London Ambulance Service.

This results from a review being conducted by NHS England.

A procurement notice published earlier this month called for suppliers to carry out an external review of commissioning arrangements for the London Ambulance Service Trust, after its performance declined significantly over the last few years.

Indeed, the trust was placed in special measures back in 2015, and has yet to be taken out of this emergency condition.

As part of the review process, recommendations will be put in place for a new model of commissioning, with the intention to commence this in April.

The notice stated that options include “centralised commissioning (eg: NHS England)”; “commissioning at a STP level”; keeping the “current model with either existing or new lead CCG commissioner”; and maintaining the current model but with “expanded commissioning support unit/CCG support”.

It has been traditional for ambulance services in London to be commissioned at the local level, and Brent clinical commissioning group has acted as a lead commissioner for thirty two groups in recent years.

The review process will be relatively frugal, costing nearly £70,000, and has been tasked with assessing “the effectiveness, value for money and efficiency of the lead CCG commissioner arrangements”.

Once all data and information has been collected, the review will then suggest ways that the system can “support effective delivery of the ambulance service’s performance and quality improvement plans”.

NHS England has asked for the review to be completed by 3rd April.

The service specification for the review notes that the London ambulance service has not run as intended over the last few years.

“In recent years there have been challenges in managing the London Ambulance Service contract and delivery where despite increased investment, underperformance against contracted performance levels has been experienced.”

And the document goes on to outline the ethos behind the review process.

“It has proved challenging to manage the London Ambulance Service contract across 32 CCGs with a history of non-delivery following significant additional investment provided in 2015-16 and 2016-17 to increase frontline staffing and, support performance and quality improvement projects which to date have delivered limited progress against key outcome measures.”

In order to assess the way that the ambulance service operates in London, “information will be sought from national NHS England colleagues on any national plans to recommend strengthening ambulance commissioning”.

An NHS England London spokesman suggested that the review could play a major role in improving the ambulance service in the capital.

“The review will look at strengthening and improving commissioning arrangements for London’s ambulance service, and is timed to take advantage of opportunities to link with the capital’s sustainability and transformation plans.”

Trust chief executive Andrew Grimshaw also offered his support to the process, indicating that the trust will collaborate closely with commissioners.

“We are aware of the review and will continue to work with commissioners to ensure future commissioning arrangements best meet the needs of Londoners.”


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