Editor’s blog Monday 26 July 2010: The amputee octopus: DH arms' length body review heralds many commercial opportunities.

The DH arms' length body review is here.

The press release says that it recommends that "the changes outlined in today’s report will reduce the number of health ALBs from eighteen to between eight and ten; they are expected to deliver savings of over £180m by 2014/15".

Super. It's almost enough money to pay for the National Cancer Drugs Fund.

And in our brave new world, the work of ALBs is going to be a money-spinner. No, really. It says, "where appropriate, arm’s-length bodies will be expected to exploit commercial opportunities and maximise commercial discipline across the sector".

For the chop are:
Alcohol Education and Research Council
Appointments Commission (which moves into the DH - how liberating and decentralising can you get?)
Health Protection Agency (which will go into the Department for Public Health)
National Patient Safety Agency (whose safety functions get retained and transferred to the National Commissioning Board - NPSA's National Research and Ethics Service functions may go to a single research regulator, and the National Clinical Assessment Service will become self-funding over the next two to three years)
National Treatment Agency for Substance Misuse (see HPA above - into DPH)
NHS Institute for Innovation and Improvement ("move functions which will support the NHS Commissioning Board in leading for quality improvement to the Board. Review the potential for its remaining functions to be delivered through alternative commercial delivery models")

Moving sector are:
Council for Healthcare Regulatory Excellence (which will become independent and charge regulators for its services)

Living to fight another day are:
Care Quality Commission
Human Fertilisation and Embryology Authority
Human Tissue Authority
Monitor
NICE (which will get to set social care standards, too)
NHS Blood and Transplant (which will be reviewed for "opportunities to make more commercially effective", with its Bio-Products Laboratory moving "out of NHSBT into a Department of Health-owned company")
NHS Business Services Authority ("ommission commercial review to identify potential for increased commercial opportunities, including potential to remove functions from the ALB sector")
NHS Litigation Authority ("commission an industry review to identify potential opportunities for greater commercial involvement")

In detail
The 'notes for editor' bit of the press release is copied below, for your reference:

Arm’s Length Body: Alcohol Education and Research Council
ALB Type: Executive Non Departmental Public Body (ENDPB) and registered charity
Role: Administers the Alcohol Education and Research Fund
Proposal: Abolish as an ALB and remove from the sector, while seeking to maximise the opportunities for effective cross-government policy to reduce the harm from alcohol misuse.

Arm’s Length Body: Appointments Commission
ALB Type: ENDPB
Role: Makes public appointments
Proposal: Abolish as an ALB during 2012 in view of the very substantial reduction in the number of appointments required. Move remaining appointments to the Department of Health.

Arm’s Length Body: Care Quality Commission
ALB Type: ENDPB
Role: Regulates health and adult social care provision
Proposal: Retain as quality inspectorate across health and social care, operating a joint licensing regime with Monitor. Host organisation for Healthwatch England. Current responsibility of assessing NHS commissioning moves to the NHS Commissioning Board. May gain functions from other organisations, e.g. HTA and HFEA.

Arm’s Length Body: Council for Healthcare Regulatory Excellence
ALB Type: ENDPB
Role: Oversees professional regulators
Proposal: Remove from the sector. Make a self-funding body by charging a levy on regulators. Extend role to set standards for and quality assure voluntary registers.

Arm’s Length Body: General Social Care Council
ALB Type: ENDPB
Role: Regulates social workers
Proposal: Transfer the regulation of social workers to the Health Professions Council, which will be renamed to reflect its new remit.

Arm’s Length Body: Health and Social Care Information Centre
ALB Type: Special Health Authority (SpHA)
Role: Collects and provides health and social care information
Proposal: Retain, and put on a firmer statutory footing by establishing it in primary legislation. National repository for data collection across health care, public health and adult social care. Clearer focus on data collection, with a close working relationship with the NHS Commissioning Board.

Arm’s Length Body: Health Protection Agency
ALB Type: ENDPB
Role: Protects the health and wellbeing of the population
Proposal: Abolish as a statutory organisation and transfer functions to the Secretary of State as part of the new Public Health Service.

Arm’s Length Body: Human Fertilisation and Embryology Authority  
ALB Type: ENDPB
Role: Regulates human embryo storage, research and assisted reproduction treatment
Proposal: Retain as a separate ALB for the time being, with the aim of transferring its functions by the end of the current Parliament. In the meantime, we will examine the practicalities (and legal implications) of how to divide the HFEA’s functions between a new research regulator, the Care Quality Commission and the Health and Social Care Information Centre.


Arm’s Length Body: Human Tissue Authority
ALB Type: ENDPB
Role: Regulates the removal, storage and use of human tissue and organs
Proposal: Retain as a separate ALB for the time being, with the aim of transferring its functions by the end of the current Parliament. In the meantime, we will examine the practicalities (and legal implications) of how to divide the HTA’s functions between a new research regulator, the Care Quality Commission and the Health and Social Care Information Centre.

Arm’s Length Body: Medicines and Healthcare products Regulatory Agency
ALB Type: Executive agency
Role: Regulates medical devices and medicines
Proposal: Retain, but with the expectation that it will undertake its regulatory duties in the most cost effective way.

Arm’s Length Body: Monitor
ALB Type: ENDPB
Role: Assesses, licences and monitors NHS Foundation Trusts
Proposal: Retain and make an economic regulator, operating a joint licensing regime with CQC.

Arm’s Length Body: National Institute for Health and Clinical Excellence
ALB Type: SpHA
Role: Provides national guidance on the promotion of good health and the prevention and treatment of ill-health
Proposal: Retain, and put on a firmer statutory footing by establishing it in primary legislation. Expand scope to include social care standards.

Arm’s Length Body: National Patient Safety Agency
ALB Type: SpHA
Role: Promotes patient safety and manages the National Clinical Assessment Service, the National Research Ethics Service and confidential enquiries.
Proposal: Abolish as an ALB. Safety functions retained and transferred to the National Commissioning Board. Explore transfer of National Research and Ethics Service functions to single research regulator. National Clinical Assessment Service to become self-funding over the next two to three years.

Arm’s Length Body: National Treatment Agency for Substance Misuse
ALB Type: SpHA
Role: Works to increase the availability, capacity and effectiveness of drug treatment in England  
Proposal: Abolish as an ALB, and transfer functions to the Secretary of State as part of the new Public Health Service.

Arm’s Length Body: NHS Blood and Transplant
ALB Type: SpHA
Role: Provides blood, organs and associated services to the NHS
Proposal: Retain, and commission an in-depth review of opportunities to make more commercially effective. Transfer Bio-Products Laboratory out of NHSBT into a Department of Health owned company.

Arm’s Length Body: NHS Business Services Authority  
ALB Type: SpHA
Role: Provides central services to the NHS
Proposal: Retain in short term, and commission commercial review to identify potential for increased commercial opportunities, including potential to remove functions from the ALB sector.

Arm’s Length Body: NHS Institute for Innovation and Improvement
ALB Type: SpHA
Role: Supports the NHS by spreading new ways of working, new technology and leadership
Proposal: Remove from ALB sector. Move functions which will support the NHS Commissioning Board in leading for quality improvement to the Board. Review the potential for its remaining functions to be delivered through alternative commercial delivery models.

Arm’s Length Body: NHS Litigation Authority
ALB Type: SpHA
Role: Handles negligence claims and works to improve risk management practices in the NHS  
Proposal: Retain, and commission an industry review to identify potential opportunities for greater commercial involvement.

One last, intriguing note for editors
"This review cover the Department’s eighteen Arms Length Bodies at present. The White Paper, Equity and Excellence: Liberating the NHS, proposed the establishment of the NHS Commissioning Board. Ministers are also considering the establishment of a single research regulator. Subject to this the Human Fertilisation and Embryology Authority and the Human Tissue Authority will be abolished. The maximum number of ALBs will therefore be ten. However, following the further identification of opportunities  for commercial involvement, the NHS Business Services Authority and the NHS Litigation Authority functions within the ALB sector may be reduced or removed.

My underlining. So what do you think?