A 50% reduction in funding has raised question about how well the NCB will be able to function
A report setting out how much funding the NHS Commissioning Board is to receive and the risks it faces has been published.
The document, issued by the NHS Commissioning Board Authority, the precursor to the final NCB, says the running costs of the organisation in 2014-15 will be £492m – a 50% reduction in previous funding.
In the outline of how the NCB will work, which includes details on the organisational structure and workforce numbers, the document acknowledges the risk in the "delivery of functions with 50% less resources".
However, the report states there will be a one-off extra fund to aid transition in 2013-14 – the board's first full year of operation.
Other anticipated risks include differences with the Department of Health (DH) over what is included in the £492m figure, pressure to take on extra functions without funding and whether resources and business processes will be in place by 2014-15.
While the cost of commissioning public health services on behalf of Public Health England, a department within the DH, will be funded separately, there will be funding for a new leadership academy.
The report says work is still continuing with the DH to "identify the full costs associated with delivering information standards, governance, national IT applications, infrastructure and services".
The board emphasises a move to local areas across four commissioning areas. These will be based on areas now covered by current Strategic Health Authority clusters but will be "significantly smaller and will not operate as separate entities in their own right," the report says.
The overall workforce will number 3,500 full-time equivalent staff, including 2,500 across 50 local offices, which will each hold around 50 staff. "To carry out its key functions of direct commissioning, supporting and assuring CCGs and managing relationships with local stakeholders, the board will have to deploy the majority of its staff at sub-national level," the authority says.
Some local offices will run services on behalf of others and so workforce size and funding will vary. Areas which could be taken over by local offices could include:
• Specialised and primary care commissioning.
• Military and offender health.
• Support for clinical networks.
• Family health services.
The authority says that quality, clinical leadership, patient and public voice, promoting equality and reducing health inequalities would be "hard-wired" into the new organisation and one of the board's key direct commissioning responsibilities will be for specialised services, which are currently commissioned at national or regional level.
Responsibility for these will lie across a number of directorates, including medical, nursing, commissioning and operations, with the latter responsible for the assurance and assessment of CCGs, the NHS constitution and "information flows to allow public and parliamentary accountability".
The NCB will be based primarily in Leeds but there will be opportunities for flexible working and working within a number of local offices, yet to be determined, and other teams. Guardian Healthcare Network