NHS England » Specialised services clinical priorities advisory group (CPAG) terms of reference

Purpose

1. The Specialised Services Clinical Priorities Advisory Group (CPAG) is a non-executive advisory committee established by the Board to make recommendations to NHS England about which new treatments, services and technologies should be prioritised for inclusion in prescribed specialised services routine commissioning and could be funded by potential discretionary spend within the annual Specialised Commissioning budget allocation.

Delegated responsibilities

2. To provide clear and consistent recommendations to the National Commissioning Group/Delegated Commissioning Group on the prioritisation for routine commissioning of clinical services, treatments and technologies that:

are within the scope of ‘prescribed specialised services’ for which NHS England has retained responsibility for commissioning or NHS England/Integrated Care Boards have joint responsibility for commissioning; and
are not being (or expected to be) evaluated by the National Institute for Health and Care Excellence (NICE)

3. To make these recommendations by applying the principles and criteria of the decision- making framework that strengthens the focus on effectiveness and value-for-money for relative prioritisation decisions.

4. To provide assurance that the draft clinical commissioning policy or service specification propositions (in year service developments only) have been developed through the correct process, evidence review, impact assessments, stakeholder engagement and public consultation received from the National Programmes of Care (NPoCs).

5. Members are expected to observe the highest standards of impartiality, integrity and objectivity in relation to the advice provided; and to abide by the principle of collective responsibility, standing by the recommendations of the Group and not speak against them in public.

6. To produce a report explaining the reasons for each CPAG recommendation to the National Commissioning Group/Delegated Commissioning Group and demonstrating that the process to reach the recommendation has been transparent, has taken account of available guidance, has engaged the public and patients, and has included public sector equality duty considerations.

7. The Rare Disease Advisory Group (RDAG) will provide advice to CPAG on highly specialised treatments, services and technologies to assist CPAG decision-making.

Governance

8. CPAG will be accountable and provide recommendations to the National Commissioning Group/Delegated Commissioning Group. The chair of this Group approves the ToR and membership (with the exception of themselves).

9. Quoracy is reached when at least a medical director, a commissioning director (or delegated deputy), a finance director (or delegated deputy) and a Patient and Public Voice (PPV) representative are present.

10. Members should aim to arrive at recommendations by a consensus. Where consensus cannot be reached, a simple majority of the present voting members (excluding the chair) is required. Abstentions are not considered when determining the majority. The chair will cast their vote only when the majority is not achieved.

11. The Secretariat is provided by NHS England Specialised Commissioning Clinical Effectiveness Team. The Secretariat is responsible, along with the chair, for ensuring that CPAG operates within its Terms of Reference.

Membership

12. The chair and members of CPAG will be appointed for a period of up to three years, with the exception of members who sit on CPAG by virtue of their individual institutional roles. The chair and members can be re-appointed through a transparent application and interview process.

13. Formal membership:

chair
director of clinical commissioning, specialised commissioning
finance director, specialised commissioning
quality and nursing representative
3 regional medical directors of commissioning
regional director of commissioning
public health representative
patient and public involvement members (x4)

14. Additionally, the chair can invite people with additional expertise/knowledge to support CPAG decision-making to be ‘in attendance’ at CPAG meeting (i.e. to contribute to meetings, but not have voting rights). Representatives of the devolved nations are invited to attend as observers.

Declaration of interest

15. All members of CPAG must declare their relevant personal, non-personal, pecuniary interests or potential ones. An interest is relevant if it has occurred in the last twelve months or if it is a current or planned involvement. The chair will determine whether any conflict is such as to require the member not to participate in the discussion or the decision-making. The chair or deputy should not have a personal interest in any agenda item under discussion – they can nominate another appropriate member to act as chair for a specific item.

Terms of reference review date