Michael Sobanja

Policy Director at NHS Alliance

Author of: What is commissioning?

An experienced senior executive, Michael Sobanja is also a management consultant, facilitator and trainer, with clients drawn mainly from the NHS, the pharmaceutical industry and local government. He is an advisor to, and non–executive director of, a number of commercial companies that operate in the health and heath care environment. He is currently the Policy Director of the NHS Alliance, having been the Chief Executive of the organisation since its inception in early 1998.

The Alliance is a national membership organisation for both organisations and individuals in primary care across the UK, with a key role in representation, development and dissemination of good practice.  He was also an originating board member of the European Forum for Primary Care and now a Special Advisor and Chair of Health Equality Europe, an organisation that focuses on health equality issues from a patient perspective. He has been a member of the UK Vision Strategy Advisory Group for the last three years.

A regular speaker at conferences both nationally and internationally, he writes for several national publications and is a member of a number of editorial and advisory boards. He works closely with a number of government agencies on the development and implementation of health policy.

Michael was previously a chief executive of a large Health Authority and has thirty years worth of management experience in the NHS and health care fields. A qualified member of the Institute of Healthcare Management, he also holds qualifications in Health Economics and the Institute of Directors’ Diploma in Company Direction. He is a Fellow of the Royal Society of Medicine.

Summary: What is commissioning?

  • The origin of commissioning rests in a 1989 political attempt to revive an ailing NHS.
  • The purchaser–provider split aimed to separate bodies concerned with the ’what‘ from those concerned with the ’how’.
  • Commissioning responsibilities are now divided across NHS England, clinical commissioning groups (CCGs) and local authorities.
  • Co-commissioning is a term that may apply to both specialised commissioning and primary care commissioning. It seeks to involve CCGs in commissioning services for which NHS England is legally accountable.
  • Specialised commissioning is concerned with services provided in relatively few hospitals but these usually have catchment populations of more than one million people. The budget is £15.6 billion.
  • More than half of all CCGs have taken devolved responsibility for commissioning general practice services from 1st April 2016.
  • Commissioning support units (CSUs) provide business services to commissioners. There are currently six NHS CSUs.
  • NHS finances are under immense pressure. A provider overspend of £2.45 billion in 2015/16 was offset by a national underspend by NHS England and specialised commissioning.
  • In 2015/16, 62 CCGs reported underspends totalling £122 million against their annual plan, while 39 CCGs reported overspends totalling £151 million.
  • The Cancer Drugs Fund overspent by £126 million (37%) despite reprioritisations undertaken during the year.
  • From 1st April 2016, the Greater Manchester Combined Authority took control of a £6 billion health and social care budget.
  • Further devolution arrangements, varying in their type, have been announced. These involve Cornwall, Liverpool and London.
  • The Five Year Forward View sets the scene for the period up to 2020.
  • From 2016, every health and care system in England (44 in total) will produce a multi-year Sustainability and Transformation Plan (STP), showing how local services will evolve and become sustainable over the next five years.