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Commissioning Policy Review


Clinical Commissioning Groups have a duty to spend public money wisely.  As there is only a set amount of money available to spend, we have to make difficult decisions about which treatments are routinely provided.

Most of the services/treatments we commission are provided for our whole population. However, some are only clinically effective in very specific situations or for a very narrow group of patients.

In such cases, we need to commission these services/treatments on a named individual (patient) basis, having first decided that there is evidence that the proposed treatment is clinically effective and that the patient should see a demonstrable benefit from receiving the treatment.

The Commissioning Policy Review

The NHS never stands still. Advances in science mean it is constantly evolving to keep pace with the invention of new drugs, new treatments and new technology.

As new treatments and services become available, demand goes up and we will have to make tough decisions on how to spend our limited budget for the benefit of our whole population.

We will need to do this in a number of ways:

  • we may need to prioritise certain treatments and procedures
  • we may have to set “thresholds” (or a defined set of criteria) that a patient must fit before they can be referred for particular treatments or procedures. This is because some treatments only work in very specific clinical situations or for a very narrow group of patients
  • there are circumstances when we can only fund certain procedures or treatments if there are clinical grounds for doing so


We have only existed as a statutory NHS body since 1st April 2013.  As a result, some of our commissioning policies need reviewing and updating - which will include financial decision making.

We require the feedback on our draft Commissioning Policy that is currently being reviewed by Cheshire and Merseyside Commissioning Support Unit on behalf of the CCG.  This policy incorporates procedures of lower clinical priority and Infertility.

What are the main policy changes?

  • Updated guidance based on new evidence
  • Addition of new services/treatments/procedures that have come on stream since old policies were adopted


Please note: the responsibility to commission some services have now transferred to NHS Specialised Commissioning which is part of NHS England.  To learn more about NHS Specialised Commissioning go to

Which services are affected?

There are a number of services which are affected, including procedures of lower clinical priority and Infertility. A full list can be seen by CLICKING HERE. To view more information, please double click on any of the specialties/clinical areas that are listed. This will take you to:

  • an easy-to-read explanation of the service area and the new guidance
  • how you can give us your views


A list of the services can also be seen by viewing the full policy document.

AUDIO VERSION: To assist people with visual impairment we have produced audio versions of all the Policy Review information. Each clinical speciality is listed separately and there are full version and easy read versions covering each speciality.

To listen to the audio versions please CLICK HERE 

We have used a colour key to show whether the proposed changes to a specific service/treatment area are important, less important, not important or there are very minor changes or no changes at all:

  • Red – important
  • Amber - less important (e.g. a change of criteria)
  • Green - not important (e.g. a minor change to the policy or a change to the wording in the policy) or there are very minor changes or no changes at all.
  • Blue – the blue category covers new treatments or procedures that did not appear in the previous policy. These have been colour-coded as:
    • Dark Blue (important impact)
    • Mid Blue (moderate impact)
    • Light Blue (minor impact)

What happens next?

Following a period of clinical and public engagement, the CCG will need to consider:

  • whether we want to adopt and put into practice this updated policy
  • if we do want to put it into practice, we will need to find the funds to pay for it from our existing budget.

If we choose to adopt the updated policy, the CCG has two options

  1. put the new policy into practice as soon as possible, or
  2. phase in over a period of time to reduce the financial impact

Before we can make these key decisions, we are seeking feedback from a wide range of people – not just doctors and nurses and other healthcare experts but importantly members of the public, existing patients, carers and partner organisations.

As a patient or member of the public:

You have the right to feed your views into this decision-making process

Your feedback is needed by 12 noon Monday 7th April 2014. PLEASE NOTE THAT THIS CONSULTATION IS NOW CLOSED

Come along to one of our public meetings: 

Wednesday 5th March         Congleton Library Meeting Room            6.00pm - 8.00pm 

Wednesday 12th March       Wilmslow Library Meeting Room              6.00pm - 8.00pm

Friday 14th March                Poynton Civic Centre                               6.00pm - 8.00pm

Tuesday 18th March           Silk Room, Macclesfield Town Hall            6.00pm - 8.00pm

All the feedback that is received will be taken into account before a decision is made.

If you require a hard copy of this information via post please contact the Cheshire and Merseyside Commissioning Support Unit Customer Solutions team on 0800 218 2333.

If you are hard of hearing, have sight impairment, English is not your first language or you require this information in an easy read format please contact the Customer Solutions team on 0800 218 2333.