The ICB receives a fixed budget from central government and must arrange for the provision of healthcare to the extent it considers necessary to meet the reasonable requirements of its patients, subject to the statutory duty to stay within its allocated resources.
Directly commissioned services include those provided through primary, secondary and tertiary care providers, the independent sector, voluntary agencies and independent NHS contractors.
The ICB seeks to take decisions about which services to commission through a systematic approach which is centred on the needs of the patient but which fairly distributes services across different patient groups. Given resource constraints, the ICB cannot meet every healthcare need of all patients within its area of responsibility. The fact that the ICB takes a decision not to commission a service to meet a specific healthcare need due to resource constraints does not indicate that the ICB is breaching its statutory obligations. The mechanism through which investment and disinvestment decisions are taken is through a range of ICB processes.
This priority setting process is supported by a series of generic commissioning policies which can be accessed below:
