Prioritisation of Services

In line with NHS England national policy, each Clinical Commissioning Group (CCG) has an obligation to provide a fair system for deciding which treatments to commission (buy). NHS commissioning bodies have limited budgets with which to purchase services for the populations they serve and in some instances may not be able to fulfil the wishes of all patients within its areas of responsibility.

Each CCG has a Clinical Priorities Advisory Group (CPAG) which considers which services, treatments and interventions should be prioritised for investment. This framework supports a fair and systematic approach to decision making, focused on patients’ clinical needs based on clearly defined criteria.

The Modified Portsmouth Scorecard is a tool that helps CCGs in making decisions by assessing many factors. It is a recognised method of reaching decisions in complex cases that require a choice between alternatives. CPAG uses these scorecards to assess the relative clinical priority of the services, treatments and interventions (the topics) they purchase so they can be ranked in order of value to patients.

The six CCGs across Staffordshire, including North Staffordshire and Stoke-on-Trent CCGs, have applied this process for several years using similar criteria across the county. The local priorities have now been combined into a comprehensive list of all the services and interventions commissioned by the CCGs across the whole of Staffordshire.

The interventions on this list are ranked according to their relative clinical value based on the benefits to the health of patients. The CCGs will continue to assess those services which are currently offered and any new treatments using this prioritisation process.

A list of the health topics to be considered in the coming months by CPAGs across Staffordshire will be posted by the end of January. This will be renewed every three months but topics may be added at any time. These topics may be healthcare interventions, services or clinical pathways. The key questions for each topic will be included.

Where it is relevant to a CPAG’s discussion, people and organisations with an interest in the topics being discussed are invited to submit relevant evidence relating to both the clinical and cost-effectiveness of the topic.  The CPAG will consider scientific evidence which can be sent as PDF documents or references to This email address is being protected from spambots. You need JavaScript enabled to view it. by the closing date listed.

The sender is asked to include their name, organisation and position within the organisation, or name and address if sending as an individual.  An automatic acknowledgement will be sent to those who supply an email address; however the CCG will not enter into correspondence at this stage.

The first draft summary of evidence will be posted before the appropriate closing date.  This draft will indicate the likely assessment of each of the criteria, but not give an indicative score.  Comments and further evidence would need to be received by the date specified.

There may be occasions when the CCG needs to fast track an assessment when there is some urgency in deciding whether it is a priority for a group of patients.