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NHS England has told {Clinical} commissioners to suspend all GP out of hours and NHS 111 procurements while it draws up new rules for creating ‘functionally integrated’ urgent care services, LGC’s sister title Health Service Journal has learned.

Commissioners told to suspend all procurements out of hours and NHS 111 services. NHS England drawing up new rules plan for “functionally integrated” services. National body signals move to commissioning across larger patches and “leader providers

A letter from commissioning operations director Dame Barbara Hakin said clinical commissioning groups should suspend the procurements, regardless of the stage reached until September.

The moratorium has been called to give the national body time to draw up a set of commissioning standards and a clinical model for what is described as a “functionally integrated urgent care access, treatment and clinical advice service”.

These new services will join up 24/7 urgent care access with treatment and advice, and incorporate current NHS 111 and out of hours provision, according to the letter, which was sent to CCGs and 111 providers on Friday. (10th July)

At present these services are often procured separately and across areas of various different sizes.

Dame Barbara wrote:  “Further procurements of NHS 111 and OOH services should be suspended, whatever stage of the procurement has been reached, until the end of September, to allow completion of the consultation and the release of the revised commissioning standards and supporting procurement advice for integrated services.

Barbara Hakin has told CCGs to suspend procurements until September, regardless of what stage they are at

The letter, seen by the Health Service Journal (HSJ) marks the start of a consultation exercise.

The letter also indicates NHS England believes commissioners should group together to plan and contract 111 and out of hours services across larger areas, potentially as large as the emerging "urgent and emergency care networks”.It said: “The lead or coordinating commissioner arrangement should be considered, in which commissioners serving a wider area are brought together to commission an integrated service.</p><p>“This has been shown in a number of areas to be an effective model for engaging with providers, particularly those that deliver services over an area covering a number of clinical commissioning groups, and to effect strategic change.”

It states that the ongoing NHS England urgent and emergency care review “envisages that an area covered by an urgent and emergency care network will, in most cases, be the most appropriate level for agreeing how a service… should be commissioned”.

Dame Barbara’s letter also said commissioners should consider moving to a “lead provider arrangement” for contracting the services, or “using the procurement process [in other ways] to encourage NHS 111 and OOH organisations to collaborate”. However, it clarified that NHS England had “no expectation” that any organisations should merge.

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Readers should be aware that the engagement events organised by Enfield CCG , Haringey CCG, CamdenCCG, BarnetCCG and IslingtonCCG already covered multiple CCGs areas and this is how the NHS111 response has been arranged (using provider London Central and West Unscheduled care Collaborative) and for LB Enfield & Haringey the services of face to face out of hours GP services using Barndoc Healthcare

Please ensure that Graham MacDougall from Enfield CCG is included on any circular letters