Senior clinical leaders from CCGs across the country have been invited by the NHS Commissioning Board (NHSCB) Authority to join a new NHS Commissioning Assembly.

The Assembly will see leaders from CCGs and the Commissioning Board work together to build an effective relationship between at a local and national level.

A letter from Sir David Nicholson (pictured), Chief Executive, Commissioning Board Authority, and 15 other CCG clinical bosses, said senior leaders were invited to be “involved in the next steps” in developing relationships.

The purpose and the roles of the Assembly will be to bring together CCG and NHSCB leaders to create shared leadership across the country to ensure clinically-led commissioning develops and flourishes.

It aims to be an infrastructure through which commissioners and the Board can together create national strategy and direction and be the mechanism that allows CCGs to have a shared voice on key issues.

Also, the Assembly will prove a learning network where the two can excel in the future.

The whole Assembly would meet once a year, Sir David proposes in the letter, as part of a learning event for commissioners.

“We propose the first Commissioning Assembly meeting could take place in late autumn 2012,” the letter said.

A series of priority areas have already been identified where CCG leads and the Commissioning Board could work together to support the development of clinical commissioning, including quality, improving primary care and strategy and innovation.

Sir David added that he hoped senior leaders accept the invitation to “join us in shaping this important set of relationships”.

The collection and reporting of patient reported outcome measures (PROMs) will remain a standard contract requirement for all providers of certain NHS services for 2012/13 and beyond.

PROMs are a key source of information on the outcomes of hip and knee replacement, varicose vein surgery and groin hernia repair procedures outlined in the NHS Outcomes Framework.

As part of the new arrangements the DH has approved four suppliers of PROMs services to assist providers of care in meeting their obligations.

Bob Ricketts, Director of NHS Provider Transition, said that Capita, Northgate, Picker and Quality Health have been assessed against “rigorous quality requirements”, to ensure they offer a high quality services to the NHS.

To help support NHS organisations meet their new PROMs obligations, the DH has created a the Patient Questionnaire Framework where they can use services offered by the four suppliers.

As part of the framework agreement, there will be greater flexibilities in collecting data at ground level. Suppliers will now be able to offer electronic data and work with other suppliers to collect and report information.

The data will be then be submitted to the Health and Social Care Information Centre’s new PROMs Clearing House service where, to meet demand, clinical teams can access patient identifiable data.

The DH notes that the new approach allows NHS organisations to call off other patient questionnaire services.

“In order to call-off services under the Framework, providers will be required to undertake a ‘mini-competition’,” said Mr Ricketts. “Providers would issue Call-Off Notices to all Suppliers setting out the specification of the services required. All Suppliers are required to submit tenders against the specifications.”

Roche has questioned the methods used by NICE in its appraisal of Avastin (bevacizumab) after it was not recommended as a first line treatment for advanced breast cancer in draft guidance.

Avastin, in combination with Xeloda, was being appraised in patients whom treatment with chemotherapy options, including taxanes or anthracyclines, is not considered appropriate.

However, Roche said NICE had a “lack of belief in a biologically plausible explanation for why Avastin works so well” which resulted in the failure to recommend the treatment.

The Swiss-based company claim the Institute ignored the progression free survival (PFS) and overall survival benefits of the drug demonstrated in clinical trials. Instead Roche said NICE chose to review data in the context of the entire population of women with metastatic breast cancer.

NICE admits evidence supplied by Roche did suggest Avastin “could delay cancer from progressing” longer than Xeloda alone, but said there was no evidence which showed it led to “an improvement in overall survival”.

Sir Andrew Dillon added there was no information available on whether Avastin improves a patient’s quality of life. “Taking these uncertainties into account as well as the high cost of the drug, the committee concluded that bevacizumab was not a cost-effective use of NHS resources,” he said.

Patients with metastatic breast cancer can still apply for access of Avastin through the Cancer Drugs Fund.

Final guidance is now expected in August 2012.