Working with commissioners Traditionally, the ambulance service was seen primarily as a call-handling and transportation service, encompassing some aspects of patient care. However, it is now recognised that a modern ambulance service has a pivotal role to play in the wider NHS in contributing to the overall performance of the urgent and emergency care system, acting as a conduit to other NHS services and in ensuring patients can access the facilities they need. Working with commissioners and other relevant stakeholders, NWAS are committed to developing clinical pathways that improve the patient experience and provide care closer to home. NWAS will not only provide rapid response to 999 calls and transport patients to hospital, but will act as a mobile healthcare service for the NHS. The coordinating commissioner for NWAS is NHS Blackpool, which works on behalf of the CCGs across the North West within an agreed commissioning governance framework. The governance framework includes the Strategic Partnership Board (SPB) that is responsible for setting the strategic direction of ambulance service provision, comprising membership of the sub-regional CCG Chief Operating Officers Leads and NWAS Executive Directors. The SPB is further supported by local area based ambulance commissioning groups in Manchester, Cumbria, Lancashire, Cheshire and Merseyside. Within the North West there are a total of 33 CCGs grouped together at the sub-regional county level - Cumbria, Cheshire, Lancashire, Manchester and Merseyside. Click here to view Full list of all CCGs nationwide Commissioning Governance Framework The governance framework and structure has been designed to allow the Strategic Partnership Board (SPB) to maintain the strategic oversight of the overall work plan to deliver transformational change for the ambulance service and to provide leadership to the other component groups within the framework. The other groups within the framework have been designed to allow for clinical commissioning input at both county and local levels. Each group has its own specific terms of references which to support the effective functioning of the framework, allowing the right conversations to happen in the right place, and at the right level of the system. This will support delivery of the strategic agenda and support continued improvements in performance, and further progression of the modernisation and transformation agenda. Contracting and Quality Groups - these groups are well established and are part of the contracting monitoring procedures which the Ambulance Commissioning Team at NHS Blackpool carries out in their co-ordinating commissioner role. Area Ambulance Commissioning Groups - these groups are important because they allow for a more locally focused conversation, and provide the opportunity for an area view to be formally reported back to the SPB via the Area Lead. These groups will also receive feedback from the SPB through their Area Lead, who attends the SPB meetings. As the SPB receives reports from all of the meetings within the governance structure, each of the area groups will get sight of all the information available. This will afford the opportunity for sharing best practise and lessons learned, and facilitating local commissioning conversations. The Area Groups also lead any local change required as part of the modernisation and transformation agenda. Clinical Development Group - this is a new group and was added to the governance structure following the publication of the NHS England letter in May 2013. This letter was unambiguous for commissioners in its directive to ensure there is a co-ordinated system wide response to delivering urgent care. As NWAS play a key role in urgent care delivery, this new, clinically focused ambulance group was established. The role of the Clinical Development Group (CDG) is to act as a clinical advisory and leadership group, providing a conduit between the SPB, Contracting and Quality groups, and the five Area Commissioning Groups. The CDG will have a clinical representative from each of the five county areas and the group will be responsible for evaluating existing initiatives and providing recommendations to the SPB.