Feedback invited in latest phase of clinical policy harmonisation programme

Stakeholder briefing

January 2025

NHS Cheshire and Merseyside is inviting views in the third phase of its programme reviewing clinical policies for a number of treatments in line with the latest evidence of what works best and to ensure equal access for patients.

This briefing gives an overview of the programme, along with details of how you can feedback any views about this work.

Overview 

NHS Cheshire and Merseyside inherited the clinical polices, from each of its nine predecessor clinical commissioning groups (CCGs) when it was created in July 2022.

These are policies that cover some specific treatments and procedures, which often only benefit certain groups of patients in some particular medical circumstances. The polices set out when and often where these treatments and procedures should be provided, and which patients would benefit medically from them.

Many of these policies were old and not up to date with the latest medical evidence and guidance. Additionally, whilst some policies were the same or similar across all CCGs, there were differences between others. For a number of treatments and procedures, not all CCG areas had policies in place, meaning there may have been a variation of approach for patients living in different parts of Cheshire and Merseyside.

So, NHS Cheshire and Merseyside began a review of all these policies with the aim of harmonising them, so they reflect current clinical evidence and guidance.

This work is happening in stages and once complete there will be a single suite of 113 clinical policies, giving all Cheshire and Merseyside residents equal access to these treatments and procedures.

To date 84 policies have been harmonised and published in the first two phases of this programme. Harmonising these policies did not represent a change to the way patients experience or access the treatments and procedures they cover.

This latest third phase of the programme is proposing some changes to a further 25 policies currently being worked on. In general, the proposed changes are minor, however because they could mean that the way patients access care might be different, NHS Cheshire and Merseyside is inviting views about these updated versions to help finalise and harmonise them.

Where polices are yet to be harmonised, patients continue to be treated under the existing policy of the CCG that covered the area they live in.

How policies are harmonised

Developing a single Cheshire and Merseyside suite of clinical commissioning policies is a complex programme of work and requires formal processes to be followed, such as quality and equality impact assessments, all of which takes time to complete.

The process includes reviewing the latest medical evidence and guidance and speaking to a range of parties such as hospital consultants, doctors and other medical and patient experts. It also involves reviewing all the information and data we have about how the services and treatments for these polices currently operate and our patients’ experience when accessing them.

In the majority of cases, polices have been brought in line with guidance from the NHS Evidence Based Interventions (EBI) programme and NICE, the National Institute for Health and Care Excellence but they have also considered other clinical evidence and research.

Both EBI and NICE involve patients when developing guidance to ensure they produce the highest quality guidelines possible for different treatments and procedures. So, the NHS Cheshire and Merseyside harmonisation programme benefits from this approach.

Where EBI and NICE guidance exists for specific treatments and procedures, in many cases service providers are already working in line with these guidelines. In these circumstances patients will not experience any change as a result of these policies being harmonised, even where a policy might not have been in place previously for a particular area.

This was the case for policies in phases one and two of the programme. All policies that have been harmonised and approved so far, which supersede any former CCG versions, can be found on the NHS Cheshire and Merseyside website https://www.cheshireandmerseyside.nhs.uk/your-health/policies/.

Where no EBI and NICE guidance exists, or where a change is proposed to patient access or treatment – as is the case for this current phase – a wider and more detailed review of clinical evidence and research is carried out, along with feedback being sought from residents and other interested parties to inform the finalisation and harmonisation of these policies.

How to give your views

People are invited to complete a short online survey about any or all of the following 25 draft policies they are interested in as part of this third phase of the programme.

Clinical policies – share your views – NHS Cheshire and Merseyside

The survey explains what changes are being proposed for each of the draft harmonised clinical policies. https://www.surveymonkey.com/r/NHSCM-CP3

The deadline for responses is Wednesday, 19 February 2025.

Your queries

Anyone with queries about the survey, or who needs advice or support should contact engagement@cheshireandmerseyside.nhs.uk