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Header image for the current page Direct commissioning delegation

Supporting the delegation of NHS England direct commissioning services

Arden & GEM has been providing effective support services to NHS England direct commissioning since 2013.

During this time, we have amassed extensive experience in supporting direct commissioning functions at a national and regional level with business intelligence, strategic clinical procurement and a variety of other commercial solutions. This has enabled the effective commissioning of specialised, secondary care dental, health and justice, armed forces and public health section 7a services.

Our award-winning collaborative work with specialised services, which accounts for 90% of direct commissioning spend, has helped to inform planning, improve access, deliver savings and monitor quality.

The process of delegating some directly commissioned services from NHE England to Integrated Care Boards (ICBs) is underway and is currently expected to progress in accordance with the following timelines:

Commencement date Service details
April 2023 All ICBs will take on responsibility for commissioning secondary care dental services
April 2024 Some specialised services (those identified as suitable and ready for delegation) will be subject to service delegation and potentially public health section 7a
April 2025 A further cohort of specialised services are expected to be subject to delegation

The legal establishment of ICBs in July 2022 addresses the ambition of giving systems responsibility for managing local population health needs, tackling inequalities and addressing fragmented pathways of care. Our experience in supporting direct commissioning provides an opportunity to translate this knowledge and insight to our work with both ICBs and providers to deliver integration which improves service quality and patient outcomes. We can support ICBs in understanding the scope and scale of delegated commissioning and maximising value for their entire population.

Our support includes:

  • Delegated commissioning due diligence – supporting systems in readying themselves for service delegation. This includes sharing insights regarding service provision, supporting data flows and business intelligence. Support with the development of commissioning frameworks, programme management for implementation and completion of key assurance documentation necessary for delegation.
  • Clinical analytics – connecting national and local data flows, clinical registries and input from subject matter experts to help ICBs, clinical networks and programmes of care better understand clinical pathways and opportunities for improvement
  • Optimising procurement of medical devices – by leveraging clinically-led, evidence-based consolidation of device usage to enable more cost-effective procurement, providing challenge to device procurement behaviours and seeking to optimise clinical outcomes for patients.

Our support can be delivered at a national, regional, system and organisational footprint with programme management experts on hand to ensure effective implementation.

Our key strengths and expertise:

We combine expertise across data, analytics, finance, procurement, contracting, clinical leadership and medicines optimisation, bringing together multidisciplinary teams that are able to complement your existing capacity and capability.

Our business intelligence and commercial teams have worked closely with national and regional direct commissioning services for over nine years, giving them a unique understanding of the sector and its challenges.

We are able to share learning and best practice across regions and systems to transform care, including for small cohorts of patients with complex needs.

Service benefits

Our direct commissioning solution will help you to:

  • Better connect the pathway of care between specialised, primary, community and secondary services
  • Invest in interventions that achieve best value for your population with the greatest impact on outcomes
  • Design holistic care that centres on patient need
  • Improve service quality.



Find out more about our work to support direct commissioning through the resources below.


If you'd like to find out more about our direct commissioning solutions, please fill in the form below: