Recommendation 138

Commissioners’ contingency plans

Commissioners should have contingency plans with regard to the protection of patients from harm, where it is found they are at risk from substandard or unsafe services.

Commissioners must develop plans to ensure that safe and effective services can continue to be provided in the event of a provider failure.

NHS England is supporting commissioners to develop plans for responding to a serious provider failure, in line with Monitor’s guidance and rules on service continuity.

The Department of Health, the Care Quality Commission, NHS England, Monitor and the NHS Trust Development Authority are working together to develop a single failure regime (outlined in the response to recommendation 19), which will ensure that financial and quality failures are handled in a consistent way and can be enacted where risks to quality and patient safety are identified.  As part of that regime, the Care Quality Commission, NHS Trust Development Authority and Monitor will work together, with the trust and its commissioners, to ensure that where concerns are raised, the trust acts swiftly to resolve them.  This will provide external support and assurance that appropriate action has been taken or may indicate that further action is needed.


With support from NHS England, many commissioners have developed plans for responding to a serious provider failure, in line with Monitor’s service continuity guidance. All clinical commissioning groups will be required to have these plans in place by 2015/16.