Issued: 13/05/15 v1.0 Copyright © 2015, Health and Social Care Information Centre. All rights reserved.

1. Overview of Commissioning functionality There are two types of provider services within the NHS e-Referral Service, those that are available to all referrers country-wide, and those that are only available to referrers who belong to a specific organisation. The first of these provider services are typically consultant-led which are available to patients and referrers to allow patients to exercise their right to choose a clinically appropriate provider for their referral.

The second group of provider services require a ‘parent’ commissioning organisation (for example a CCG) to make these services available to their locally selected referrers. Once these have been ‘commissioned’ within the NHS e-Referral Service only those referrers within the commissioning organisation are able to see and select these services for their patients via the ‘Primary Care’ menu. Within the NHS e-Referral Service, the service provider can select whether or not to include the services they are setting up ‘on the Secondary Care menu’. By opting to do this, they are making the service visible to everyone. All other services will have to have start dates (and optional end dates) added within the system by the commissioning organisation to make them visible to local referrers.

Setting these start (and finish) dates within NHS e-Referral Service is called setting up a ‘Commissioning Rule’.

To set up ‘Commissioning Rules’ in the NHS e-Referral service someone within the commissioning organisation must have a valid smartcard to which the business function of B1106 – Maintain Commissioned Services, has been assigned.

A step by step guide on how to commission a service can be found at the end of this document in Appendix 1

2. Enhancements to Commissioning functionality in the NHS e-Referral Service

The basic functionality to commission a service will continue with the NHS e-Referral Service but there are three enhancements that are now available:

The ability to commission a service at a referring organisation level The ability to manage referrals to the end of the contract date The ability to copy commissioning rules from one commissioning organisation to another

2.1 Commissioning at referring organisation level

This will allow commissioners to ensure certain services are only visible to selected referring organisations. For example, it might be useful to be able to make a specific localised service available to a small number of referring practices within a larger commissioning organisation.

Previously in Choose and Book the service restriction functionality would need to have been used to support such a pathway. However, this had the result that all practices within the commissioning organisation would still have been able to see the service, but may not have

NHS e-Referral Service

Commissioning in the NHS e-Referral Service

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been able to refer their patients to it. This new functionality ensures that the locally commissioned service is not actually visible to the other practices with in the commissioning organisation and so avoids potential confusion for referrers.

A step by step guide on how to manage this through the NHS e-Referral Service can be found in Appendix 2.

2.2 Commissioning to end date of contract

This new functionality will allow service providers to manage patients within the system to the Commissioning Rule end date – whilst setting a date to stop new referrals being sent to providers beyond the contract end date.

A commissioner can now set a ‘from’ and ‘to’ date in the ‘Effective Date Range for Contract field’. This sets the dates during which the service will be visible to the referring organisations for which the service is commissioned.

The commissioner can then enter a ‘Commissioning Rule End Date’ which is the agreed time that a provider then has to manage any referrals booked or shortlisted to the service.

Previously in Choose and Book, as soon as a service had an end date to the commissioning rule, any patients who had the service on their shortlist were unable to book an appointment, or the provider manage or change the bookings after this time.

For example:

A service is commissioned until 31st March 2016 – so the Effective Dare Range for contract would be set to 31/03/2016

There is provision for the provider to receive new referrals till 31st March but a Commissioning Rule End Date set to 30/04/2016 would allow for any bookings or provider changes to appointments up to the 30th April 2016.

2.3 Copying commissioning rules from one commissioning organisation to another

This new functionality will support the merge, demerge and any reorganisation of commissioning organisations in the future, without the need for extensive preparation work within the NHS e-Referral Service and will help ensure continuity of services for their referring organisations.

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Currently in Choose and Book if a new commissioning organisation is being formed (by a merger for example) all commissioning rules would have to be set before the referring organisations are moved to the new organisation.

This new functionality will now allow a commissioner via a Commissioning Rule enquiry to copy any commissioning rules already set by another commissioning organisation.

A step by step guide on how to copy commissioning rules can be found in Appendix 3

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Appendices Appendix 1 How to ‘commission’ a service on the NHS e-Referral Service

On accessing the NHS e-Referral Service using the Commissioner role the Commissioning Builder screen is displayed (Figure 1)

Figure 1: Commissioning Builder screen

The Commissioning builder in the NHS e-Referral Service will only display services that are available on the Primary Care menu within the system. To find a service, first search on the specialty of the service (Figure 2).

Figure 2: Select Specialty

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The specialties are accessed via the drop down box shown above in Figure 2. The specialties are displayed in alphabetical order. Highlight the specialty of the service. For example, the ‘Community Dermatology Service’ would be found by selecting the specialty of ‘Dermatology’.

Once the correct specialty has been selected, (there is no need to add a clinic type into the search), clicking the ‘load’ button (as shown in Figure 3) will return the services available.

Some specialties may take longer to return services than others. This is because the system will make available any services that are set up on the Primary Care menu across the whole of the country. Some specialties have more services in community settings than others, and therefore will take longer to return, such as Dermatology or ENT compared to services like Genetics.

Figure 3: Load services

Once the specialty has been selected and the organisations that provide these services have loaded, the information will be displayed as in Figure 4.

Figure 4: Returned Organisations

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The providers of the services are displayed in alphabetical order.

From this list select the organisation that provides the service which requires commissioning. If the provider runs the service at several different locations, each location will be displayed under the provider name. Each service you wish to make available at each individual location will need to be separately selected for the chosen provider (Figure 5).

Figure 5: Provider locations

Clicking on the desired location name reveals the services, as shown below (Figure 6)

Figure 6: Service name and location

To commission the service on the NHS e-Referral Service simply enter a start date in the Effective Date Range field on the right of the screen (Figure 7). No further fields have to be completed to make the service available to the GP Practices.

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Figure 7: Effective Date Range

Once a date has been entered, the button will become available. Each service should be saved as it is commissioned. Next to the name of the service will appear the letter ‘C’ indicating the service is now commissioned by your organisation. Other services that have never been commissioned by your organisation will display an ‘N’ next to the service name.

Each required service will need to be commissioned individually by following this process.

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Appendix 2 Commissioning at a referring practice level

The commissioner can either commission a Primary Care menu service for all of its referring practices (figure 1.) or choose to only make the service available to selected referring organisations.

This may be beneficial to a commissioning organisation which covers a large geographical area and which has locally commissioned services that they wish to make available to only selected referring practices.

Figure 1: Commissioning Builder screen

The NHS e-Referral Service now has the ability to look at applicable organisations that this service could be made available to. This can be achieved by expanding the shrub under the commissioning organisation’s name.

When the service is commissioned at the organisation level all the referring organisations below will automatically be ticked (Figure 2).

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Figure 2: Commissioning Builder screen with all organisations selected

If this commissioning organisation wants to make the service only available to certain referring practices then the practices that they do not want to have access to the service should be deselected (Figure 3).

Figure 3: Commissioning Builder screen with some organisations de-selected

So, in the example above, the service is commissioned by the commissioner, but is only available to one of their referring practices.

This new functionality will reduce the number of services that have been restricted and will ensure that commissioners are able to support their practices through locally agreed pathways.

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Appendix 3 Copying Commissioning Rules

The steps are listed below to enable one commissioning organisation to copy the commissioning rules set by another commissioning organisation. This functionality could be used to support merging, demerging or re-organisation of commissioning organisations.

1. Log in as the commissioner for the new organisation 2. Run a commissioning rule enquiry 3. Add the search criteria – Specialty and clinic type as displayed in Figure 1.

Figure 1: Commissioning Rules Enquiry

4. Then select the commissioning organisation (Figure 2).

Figure 2: Commissioning Organisation Search

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5. Ensure the box ‘Currently effective only’ is ticked (Figure 3)

Figure 3: Commissioning Rules Enquiry with all search criteria completed

6. Click on search

Services that are commissioned by this organisation that meet the criteria are returned (Figure 4).

Figure 4: Commissioning Rules Enquiry results screen

7. Select the services from where the commissioning rules will be copied - this will then activate the copy button – select the copy button (Figure 5).

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Figure 5: Commissioning Rules Enquiry results screen – with selected services

8. The Copy Commissioning Rules screen is displayed (Figure 6).

Figure 6: Copy Commissioning Rules screen

The commissioner can then either take the rules as they are set by the original commissioning organisation (Figure 7) or untick the Copy Contract Details from Source Organisation box (Figure 8).

If the Copy Contract Details from Source Organisation box is unticked – this then allows the commissioner to enter a new contract start date if required. This is displayed in Figure 8.

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Figure 7: Copy Commissioning Rules – settings screen

Figure 8: Copy Commissioning Rules – settings screen – active to make amendments

9. To submit, ensure the applicable organisation is selected – the Submit button is inactive until an organisation is selected

10. Then select Submit

The commissioning rules have then been copied from the commissioning organisation searched for and have been applied to the commissioning organisation that has just completed the process.