FSRH responds to Health Devolution Commission call for evidence
Date: 08 Apr 2020
Type: FSRH Consultation Responses
The Health Devolution Commission has launched a call for evidence on the value and accountability of devolved health systems. In our response, we propose that the success of devolution for SRH services depends on adequate funding, clear lines of accountability, and the co-commissioning of services. We make the case for:
Funding: Without funding, health devolution simply puts increased pressure on local authorities and GP services to deliver positive health outcomes, without providing them with the capital they need to provide holistic, integrated care. If local authorities and GPs are to fulfil their Public Health functions, they must be adequately funded.
Accountability: Overarching accountability for SRH services has not been clearly established since the introduction of the Health and Social Care Act 2012, resulting in a lack of oversight of service quality and health outcomes. NHSE should have a strong role to play in strengthening accountability in SRH outcomes in a devolved system. NHSE National Clinical Directors and regional-based National Specialty Advisers, who have a focus on prevention and women’s health, can ensure that co-commissioning in SRH works to a higher standard and is consistent across England. The local authority mandate to deliver Public Health services can be enhanced and strengthened. This requires mainstreaming standards of care at the local level.
Commissioning: The devolution of healthcare provides the opportunity for NHSE, CCGs and local authorities to deliver an integrated approach to commissioning by ending the fragmentation of services and ensuring that women can get their SRH needs met in one place. This includes the full range of SRH services, such as contraception, cervical screening, and treatment and advice about the menopause. This approach gives women the power to decide when and where to access services, rather than being limited by the commissioning arrangements of service providers.