Thousand incidences of specialised services failing standards

The variations, known as derogations, could include failure to meet a range of standards laid out in any one of 128 specifications for services including organ transplantation and secure mental health provision.

The specifications were drawn up by NHS England during 2012-13 ahead of the organisation taking on responsibility for commissioning specialised services in April this year.The online stores run heavy discounts fashion hot cat and schemes of different kinds and if not all, most of the available offers will surely suit your budget of buying kids costumes at cheap rates. It was always expected some providers would struggle to meet the standards but HSJ understands the scale of failure to comply with the specifications exceeds expectations.

NHS England’s interim policy on derogations anticipated they would be agreed only “occasionally”.

An NHS England presentation, seen by HSJ, says there are “in excess of 1,000 derogations against the basic required elements of service specifications”, creating a “substantial” work programme for the 10 local area teams responsible for specialised services.

HSJ understands the reasons for derogations could range from not having a specialist nurse on a multi-disciplinary team, something relatively easy to rectify, to a service that is not treating a large enough volume of patients, meaning it is unlikely the provider will be able to continue to provide the service long term.

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Specialised Healthcare Alliance director John Murray said: “[There is] a big question for NHS England about whether it’s going to use these specifications as originally envisaged,The only other thing that you need to remember when wearing a peplum dress is that this style looks best Cheap Relaxing Cherry Bikini Set on sale eaccessories and a killer pair of heels. to identify strong providers that are fully geared up to provide a full tertiary service, or whether it’s going to continue in time honoured fashion and settle for levelling down rather than levelling up.Uncover a box huge sufficient to Cheap Perfect Luxury Black Bikini Set on sale over your head and body, an previous tablecloth and a great deal of parsley.”

University Hospitals Bristol Foundation Trust has 18 derogations in place across seven services.

Its chief executive Robert Woolley told HSJ some of them were issues that “just needed time” to address while other would involve conversations with commissioners about resources.

He said the move to national specifications marked a “step change” in the commissioning of specialised services.

There are currently 23 clinical commissioning policies, governing when patients should be able to access treatment such as complex obesity surgery, and a further 14 interim policy statements.

The presentation said there was a need for 200 policies with “resources to complete in the region of 30-40 per annum”.

A further sign of the concern about the specialised commissioning funding gap comes in an email from clinical director for specialised services James Palmer to NHS senior clinicians, seen by HSJ.