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Post Consultation Policy

In mid-2013 the Cheshire and Merseyside Commissioning Support Unit (CSU) were commissioned by the 12 Clinical Commissioning Groups across Cheshire and Merseyside to undertake a review of the Cheshire and Merseyside Commissioning policy. This review covered 12 Clinical Commissioning Groups, 2.5 million population, 420 GP Practices and 74 individual treatment/service lines.

The review has provided a real opportunity for the Cheshire and Merseyside CCGs to jointly agree a comprehensive suite of commissioning policies based on latest National Institute for Health and Care Excellence (NICE) guidance and other clinical best practice.

The CSU undertook a seven-stage approach identified below:

Stage 1

Policy stimulation - practice or evidence

Stage 2

Evidence review

Stage 3

Pre Equality Impact Assessment

Stage 4

Production of a potential policy for CCG primary approval

Stage 5

Engagement- patients, carers, members of the public, referrers and providers

Stage 6

Review consultation findings, final approval by CCG and full Equality Impact Assessment

Stage 7

Policy Implementation and monitoring

A full evidence review was undertaken by the CSU considering NICE guidance and the most up to date clinical evidence base. This was supported by Public Health who undertook independent reviews in a number of areas.

Reviewing and developing commissioning policies required multi-disciplinary input and was recognised as being a very complex process. The review took account of 99 individual treatment lines classed as procedures of low clinical priority.  

The outcome of this review has been development of a new Cheshire and Merseyside Commissioning policy for a range of treatments, enabling:

  • a consistent approach to commissioning these treatments across the region
  • the CCG to replace both the existing regional commissioning policy, and local addendum for “procedures of limited clinical value” with a policy reflecting the most current clinical evidence


The draft Final Commissioning Policy was provided to CCGs on 2nd July 2014 with each CCG being asked to formally consider whether it would like to adopt the updated policy. The Governing Body of NHS Eastern Cheshire CCG considered and approved this policy and the Cheshire and Merseyside Commissioning Policy for Sub Fertility at its September 2014 meeting in public.

A full Equality Impact Assessment was undertaken around the Commissioning Policy Review