There has been a lot of progress in specialised commissioning since the publication of Sir David Carter's Review of Specialised Commissioning Arrangements for Specialised Services in 2006. Specialised Commissioning Groups (SCGs) are working towards designating providers of specialised services.
To date, national designation standards have been agreed for five specialised services. The National Specialised Commissioning Group is due to consider a plan for the development of further designation standards at its meeting on 3 March 2010. This plan will make recommendations about which sets of designation material are a priority for development. It will remain for individual SCGs to decide which services they choose to designate locally, a decision based on local priorities and discussion with their constituent primary care trusts.
Some Specialised Commissioning Groups (SCGs) operate a system of pooled budgets for some services. Others, while not formally contributing to a shared budget, are working towards the principle of risk-sharing.
The SCG Finance Network which includes representatives from each of the 10 SCGs have a work stream on pooled budgets. They are currently mapping the position in each SCG.
In 2009, a system for examining the skills and capabilities of specialised commissioners was developed, closely based on the primary care trust commissioning assurance process. This has been made available on a voluntary basis to strategic health authorities for them to assess specialised commissioning groups. The national specialised commissioning team is based within NHS London and could be assessed using the same system with some adaptations. The national specialised commissioning group is an advisory group reporting to Ministers on the commissioning of specialised services and the assurance process would not be suitable to assess its performance.
Strategic health authorities also assure the performance of specialised commissioning groups on an ongoing basis as part of their management of the local national health service.