- Is CSAS a lobby group, pressure group or a quango?
- What does CSAS do for NHS provider trusts?
- How is CSAS paid for?
- When was CSAS launched?
- How does CSAS add value to NICE appraisals?
- How will CSAS engage with non-lead PCTs?
- How was CSAS commissioned?
- Will the scheme engage with Welsh and Northern Irish commissioners?
- Why was Solutions for Public Health (SPH) chosen to operate the service?
- Is CSAS stopping life saving treatments?
- Isn’t CSAS putting at risk the impartiality of NICE?
- Why should PCTs be involved in NICE appraisals?
- Who should be involved in NICE appraisals?
- Who is performance managing CSAS?
- How does CSAS help PCTs?
CSAS is none of these. 152 PCTs have jointly procured CSAS via NHS Birmingham East and North. CSAS is an NHS service and is in place to help PCTs to engage with NICE and contribute knowledge and information to the Technology Appraisal Guidance process. NICE actively calls for PCT advice, as it does for public, clinician
and manufacturer consultation, as a routine part of its processes. CSAS is simply a cost effective and collaborative mechanism for this engagement. Most importantly, this will mean that NICE has the best information available when
deciding on TAGs. By participating fully PCTs can contribute to supporting NICE in determining the best quality, best value health outcomes for the population.
CSAS wasn't established to serve NHS provider trusts. Its remit is to assist NHS PCTs in England to engage as key stakeholders in NICE Appraisals.
CSAS was jointly procured by all 152 PCTs in England (via NHS Birmingham East and North PCT). Every PCT in England has agreed to jointly commission the service and pays £2000 per annum to NHS BEN to fund the contract. This represents an efficient use of resources. CSAS provides coordination and shared access to expertise to support PCTs in providing NICE with the information they have requested and give them access to high quality evidence reviews, which are of relevance to all PCTs. If PCTs were to independently commission this level of expertise the cost would be multiplied many times over. This is actually an example of efficient, high value collaborative commissioning.
CSAS has been up and running since September 2009.
CSAS helps PCTs engage and contribute knowledge and information to NICE Technology Appraisals Guidance process – as required by NICE. NICE is responsible for synthesising all the evidence and submissions it receives as part of its process.
CSAS will ensure that all PCTs have an opportunity to review NICE documentation such as ACDs. You might want to review the flowchart.
CSAS was jointly procured by all 152 PCTs in England (via NHS Birmingham East and North PCT). The service went out to public tender via OJEU (Official Journal of the European Union) in January 2009 and in May 2009, Solutions for Public Health (part of NHS Milton Keynes), was selected as the preferred provider – based on the merits of their tender submission.
CSAS was commissioned jointly by all 152 PCTs in England.
SPH was selected to run the service based on a fair, open and transparent tender process that scored SPH highest on its ability and pedigree to deliver the service and help PCTs to influence NICE TAGs.
- Has a high calibre, specialist team that is dedicated to supporting PCTs
- Brings together specialists whose collective expertise spans public health, health policy, evidence based analysis, health informatics, health economics and legal expertise in health law
- Has strong expertise in public health policy and practice
- Holds an international reputation in priority setting and resource allocation
- Has a proven track record in engaging with both clinical and non-clinical stakeholders
- Is an NHS organisation that is fully aware of and is actively contributing to the development of national policy.
The purpose of CSAS is not to stop life saving drugs and treatments. The service exists to help inform NICE guidance, which PCTs as a key stakeholder should be contributing to. Legally, PCTs are required to make funding available to fund treatments and drugs recommended by NICE. This funding comes from within their existing budgets and may therefore impact existing treatments or programmes. However, by engaging in the NICE process we can offer PCTs’ perspectives relating to achieving best health outcomes for the population, alongside that of other stakeholders.
No. In no way does CSAS infringe the impartiality and independent status of NICE. As part of each NICE Technology Appraisal, 2 named PCTs are selected to be PCT Consultees as NICE considers that PCT engagement and knowledge is a valuable contribution to the development of guidance. CSAS acts as a central point of contact to help NICE engage with PCTs in line with their existing methodology. Other consultees include manufacturers, patient groups and specialist clinicians. PCTs have for a long time been invited to engage with NICE – this is not new. CSAS simply provides a central point of contact, and a hub for administrative and analytical support, by which to do it.
NICE invites two PCTs at random to be consultees and to contribute evidence to the Technology Appraisal Committee. Currently, PCTs are the only consultees who do not have a special interest in the specific treatment being considered by NICE. As commissioners for the whole population, PCTs can offer special information about
the needs of groups of patients and the needs of the whole population, as well as information about current service provision, where a treatment might fit in a care pathway in real life clinical practice and the impact of treatments on the health of the population it commissions for.
NICE already invites key stakeholders to contribute to the development of TAGs, including patients groups, clinicians, manufacturers and PCTs. To date, PCTs have rarely responded to the invitation to contribute information as they have prioritised their local commitments and have not had available expertise or capacity. As the commissioners of all healthcare for their whole populations and as statutory budget holders, the PCT knowledge is a valuable contribution to the development of TAGs.
SPH (part of Milton Keynes PCT) who are developing and delivering the service for all 152 PCTs in England are contracted by NHS Birmingham East and North and are obliged to meet the requirements of the contract. A governance structure is in place, chaired by Birmingham East & North PCT. This includes an Advisory Board with PCT representation that drives the direction of the service.
CSAS will help PCTs participate fully in NICE Appraisals by:
- Responding to NICE’s requests within the timescales required
- By commenting on, or writing documents to inform the appraisal process, informed by population data and reviews of the clinical evidence about the intervention
- Attending and contribute to the scoping workshop when the research question is being defined
- Being an active and effective contributor at Technology Appraisal Committee meetings
- Commenting on the key reports as required.