Clinical commissioning groups call for less bureaucracy, more involvement at local level and more support

Released: 27/09/2011

Over one third of clinical commissioning groups have not been fully involved in shaping the commissioning support offer that has been put in place locally, according to a survey by the NHS Alliance/NAPC.

Although, 47% of CCGs said they were fully involved, 32% said they were not involved, with 21% replying ‘not sure’. Also, the majority of CCGs also feel restricted in the commissioning support offer available to them (46%); only 35% said they were not restricted.

Julie Wood, director of the NHS Alliance Clinical Commissioning Federation, said: “It is great to see that PCTs are working well with clinical commissioning groups, but there is a lot more work to be done. We need to ensure that all CCGs are involved locally in shaping the support available to them and, equally important, that they are aware of the choices available and are able to choose according to their specific needs.”

Also, most CCGs say that the style of working with the NHS Commissioning Board and transitional PCT clusters is too centralist (44%) and too prescriptive (19%), with only 18% saying it is about right.

Of those who feel restricted, 60% were only offered existing PCT cluster support; 40% were given no choice at all; 47% were not made aware of all possible choices, and 21% said they would have to bear the financial consequences of not taking the PCT offer.

When asked about obstacles or issues that are getting in their way in making the transition into Clinical Commissioning Groups, respondents said layers of management, bureaucracy and top down direction stifling innovation and hindering CCGs’ ability to make a difference at local level.

One respondent said: “Concerns about increasing tiers of hierarchy are being put into the system when there are already plenty of checks and balances. It doesn't feel we have any less red tape and bureaucracy at all, but hopefully still enough space to make it very different at grass roots. Please don't stifle us - we will lose the will to be involved.”

Another added: “There are too many meetings focused on structures with no relevance to empowering CCGs or transforming clinical care... This is not a liberating process - it is painful, slow and bureaucratic.”

Other survey highlights

  • Most CCGs are confident they will be ready for full authorisation to go live in April 2013 (very confident 17%, confident 43%, not sure 24%, and not confident 15%)
  • CCGs describe the emerging relationship with PCT cluster as locally enabling & permissive (35%), developmental & supportive (34%), controlling & directing (32%), performance managing & centralist (30%), mirroring previous style (28%), too early to tell (16%)
  • Only a small percentage of emerging CCGs feel confident they are commission services as they see fit within available resources: fully confident (4%), fairly confident (27%), not confident (50%), not sure (19%)
  • Obstacles/issues getting in the way of a smooth transition to CCG:
    • Lack of time
    • Lack of guidance
    • Over domination of PCT cluster
    • The day job!
    • The debt we may inherit
    • Lack of clarity about running costs
    • Cross boundary issues
    • Tiers of hierarchy & bureaucracy

Ends.

Notes to editors:

1.   This online survey was carried out by the NHS Alliance between August and September 2011, with a total of 131 respondents.

 2.   NHS Alliance brings together GP consortia, PCTs, clinicians and managers as the leading organisation in primary care. We are an independent non-political membership organisation proud to be at the forefront of clinically-led commissioning. Its leaders are all dedicated professionals, who represent the Alliance’s diverse membership, working ceaselessly to meet the challenges facing the NHS today. Find out more at www.nhsalliance.org

 3.   The National Association of Primary Care (NAPC) is a non-political, non-profit-making organisation representing and supporting the interests of all its members, both individuals and organisations working in or with primary care. It also offers support through associate membership to those bodies, which provide services to primary care or have other health-related interests. Find out more at www.napc.co.uk

 4.   For more information, please email pressoffice@nhsalliance.org or call 07772756674.

 

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