Even for policy anoraks like me some reports slip below the radar. In February, the House of Commons Committee of Public Accounts published a report on services to people with neurological conditions and found much to criticise. They found that there remains wide variation across the country in services and outcomes, just 12% of people with a neurological condition have a written care plan with links between health and social care judged as poor.
As someone who has tried hard to influence the way neurological services are commissioned and hit a brick wall, I can wholeheartedly agree with one of the Committee’s conclusions: “the confusion over commissioning responsibilities is leading to ineffective commissioning of neurological services.”
NHS England commission specialised services whilst our local clinical commissioning groups (CCGs) are responsible for other services. However, MPs found it hard to find out what constitutes specialised services and report that this has caused confusion over who should commission which services. In this area the major trauma unit at Queen Elizabeth Hospital is clearly a specialised regional service, but rehabilitation and aftercare is a grey area. Some is commissioned regionally and some locally. Moseley Hall Hospital in Birmingham provides in-patient and out-patient rehabilitation. A number of patients / service users say they do not understand why they need to travel to Birmingham and ask why such out-patient services are not available locally. The answer is that the funds for this service are controlled by NHS England (Regional) and not our local CCGs.
I recognise that moving funds from one service to another is difficult for Commissioners, but here at Headway we think on discharge from hospital rehabilitation services are best delivered locally.