Services review – update on decisions about future provision and delivery

NHS Kernow is currently reviewing the services we fund to ensure they provide the best possible clinical outcomes and value for money and meet people’s needs.

This webpage will provide updates on decisions made by our Governing Body about changes to the future provision and delivery of some services. 

Like other clinical commissioning groups around the country, it is normal and good practice for us to regularly review our services to identify where improvements can be made, or to discontinue funding them where there is no identified benefit to individuals, or if a service is no longer required.

A review of 300 services, which have a contract value up to £1million, is being carried out by experienced clinicians and managers who know and understand them.

Decisions are based on a range of criteria including value for money, outcomes, clinical effectiveness, patient experience and their ‘fit’ within the strategic direction of the health and social care system.

Mechanisms are in place to ensure we understand what positive or negative benefits may be experienced by the system, or by individuals, if we stop a service or change the way it is being delivered, if there is system duplication where the service is also provided by other organisations, if it can be provided in a different way as part of our work to transform and integrate services, or if there is a need for the service at all.

Our clinical leads and commissioning managers work closely with a range of key stakeholders – which can include service providers, individuals who use the services, clinicians and health and social care staff – in a manner proportionate to the size and value of the service. Their views are considered as part of the recommendation made to our Governing Body to inform decisions.

Commissioning services review policy and procedure

NHS Kernow's commissioning services review policy and procedure is available here

Decision making framework 

Clinical Commissioning Groups have a primary responsibility to commission care for the local population. In doing so, we have a range of statutory, legal and ethical duties, including a responsibility to make good use of public resources. We have a statutory duty not to exceed our annual financial allocations, while we also need to make substantial savings in order to continue to meet increasing demand. We are therefore faced with difficult decisions about which services to provide for our local populations, prioritising within finite resources. 

Decision making involves the exercise of judgement and discretion. The purpose of this framework is to support clear, consistent, equitable and well-communicated decision making within limited resources. 

This framework is slim and broken into three discreet areas: 

  1. Scope – the kinds of decisions the framework applies to.
  2. Considerations – the list of substantive principles to be applied.
  3. Process – the standards that should be applied to decision making.

You can read our decision making framework here.