As many of you will know, NHS Shropshire, Telford and Wrekin CCG is required by law to operate within budget constraints which means the CCG has to prioritise resources and fund interventions with the greatest proven health gain for the population it serves.
As a consequence, some referrals or interventions that patients may wish to receive, and which a clinician may wish to offer, cannot be funded. The intention is to ensure equity and fairness in respect of access to NHS funding and to ensure compliance with the NHS England Evidence Based Interventions (EBI) statutory guidance.
The Value Based Commissioning (VBC) policy sets out a range of restrictions and criteria associated with certain procedures and treatments. These are either not funded or commissioned by the CCG or, where specified, criteria have to be met for the funding of certain referrals or interventions.
Commissioners, GPs and both NHS and non-NHS service providers treating patients that fall under the remit of NHS Shropshire, Telford and Wrekin CCG are expected to implement and adhere to this policy.
The current version of the policy in place was implemented in July 2019, and following a content update and redesign the CCG Transformation & Commissioning Team is pleased to announce the refreshed VBC policy which will be implemented from the start of 2022.
The policy was approved by the Shropshire, Telford and Wrekin CCG Strategic Commissioning Committee on Wednesday 15 December 2021 and should be followed by CCG colleagues from Tuesday 1 February 2022, with all relevant referrals being assessed against policy criteria from that date onwards.
The refreshed policy includes updates from the NICE guidelines as well as Evidence Based Interventions and has been made easier to navigate and more user-friendly. The policy now includes chapters by specialty, a visual referral process flow chart, a glossary of medical terms and a FAQ section.
The NICE guidelines and EBI’s have been consulted on at a national level and the Shropshire, Telford and Wrekin CCG policy has undergone extensive local engagement both internally and with service providers. The recommended changes and additions have also been scrutinised by the CCG’s nominated VBC clinical leads.
To help minimise the time taken to seek prior approval codes, the policy now uses three simply options. These are:
- A procedure that is not funded;
- A procedure requiring referral approval by RAS/TRAQs;
- A procedure subject to audit.*
* This is where the provider makes a clinical judgement on whether the procedure should go ahead for that individual. This activity is subject to quarterly audit to ensure that clinical rationale is in place.
We are delighted to finally get this piece of work over the line following a turbulent couple of years. If any colleagues have any questions relating to the refreshed VBC policy, please contact Lucy Jones, Elective Care Project Support Officer, at: firstname.lastname@example.org.