The NHS Commissioning Board (NHSCB) has been formally established this week, in preparation for taking on full responsibilities for the commissioning of primary care and national specialised services from April next year.

Until this time, the Board will be pouring over proposals for authorisation from over 200 new clinical commissioning groups (CCGs), which are to form the lifeblood of the new clinically-led commissioning system laid out in the Health and Social Care Act. 

According to the government, CCGs have the potential to transform health outcomes in their communities, and will free the NHS from day-to-day political meddling.

"We have been given a real, once in a lifetime opportunity to do things differently, by empowering our clinical leaders and ensuring that the needs and wishes of patients truly shape the health services they receive and deserve,” said Sir David Nicholson, Chief Executive of the NHS Commissioning Board.

The government is expected to publish the final form of the Commissioning Board's mandate, detailing exactly what it expects the group to achieve, sometime this Autumn.

The first draft of the mandate was published in the Summer, but a subsequent consultation has revealed concern that the specifics are still a little thin on the ground.

In its response to the consultation, Pharmacy Voice, which represents community pharmacy owners, pointed out that the NHSCB will itself be responsible for around £20 billion of direct commissioning, including pharmaceutical services in primary care, but that the draft mandate "has little detail" on how it will be held to account for direct commissioning.

Unclear fit?

In addition, it says there are a number of areas "where it is unclear how the new system will fit together", such as how the strategic “fit” of the NHS Mandate in relation to public health and social care will be ensured, and how the NHS Outcomes Framework aligns with the Public Health Outcomes Framework and 

the Commissioning Outcomes Framework.

"We are concerned that the key quality indicators and baseline data set has not been established for pharmaceutical services, which will make it difficult for the NHSCB to achieve its objectives in improving health outcomes from those services they directly commission from pharmacy".   

The group also stressed that the NHSCB must ensure that the safe management of medicines - through the interface between patients and their community pharmacist  - "is not lost but built upon in the transformation to the new health and care system".