Clinical Commissioning Groups Addressing outstanding size and configuration issues
Released: 22/11/2011
The Clinical Commissioning Coalition, set up by the NHS Alliance and the National Association of Primary Care, has published a discussion paper on CCG size and configuration issues.
From preliminary discussions and cost analysis the paper, CCGs – Addressing outstanding size and configuration issues, notes that a CCG with less than approximately 100k population may be too small to act entirely independently with an exclusive management team and to fulfil all statutory functions.
The paper states that there is evidence to suggest that ‘to maintain a sense of localness for the clinicians forming the group, whilst having a critical mass for managing clinical and financial risk, organisations will need to have a population base of at least 100,000’.
To address some of the issues, the paper makes some recommendations, including:
- With regard to size/ flexibility and localness – in order to support innovative practices or groups of practices, discrete parts of CCGs could be given delegated authority to determine their use of budget, contract/commissioning intentions and service changes.
- CCGs will need to be sufficiently flexible to allow the different patches or operating areas to develop at variable speed.
- With regard to geography, guidance should be clarified to ensure that there is no overlap of population responsibility between CCGs.
- With regard to proportionate governance, it is suggested that Chairs, Accountable Officers and other Governing Body members can be shared in the same way as they are shared now between SHAs and PCTs as long as there is a clear governance framework that specifies who is responsible for what.
Mike Ramsden, Chief Executive of NAPC commented: “This is a very useful document for CCGs, though not yet completely finalised, and will provide smaller CCGs with food for thought on the options before them, in terms of managing risk, and financial autonomy.
“A missing piece of the jigsaw, however, is the Secretary of State’s expected announcement on management allowances for smaller CCGs, which should be published shortly and will enable interim decisions to be taken on local CCG configurations.”
Julie Wood, National Director, NHS Alliance, said: “This is work in progress and the paper will be refined following discussions with a number of CCG leaders. Localism, flexibility and identity are critical for CCGs so we need to look at a number of models CCGs of different sizes could use, such as incorporate delegated budgets for prescribing, community services and acute services.”
A meeting of a small group of CCGs has been scheduled for the 14th of December and a revised paper will be published for wider discussion, with a view to complete the work by the end of January 2012.
Ends.
Notes to editors:
1. Julie Wood, National Director, Clinical Commissioning, NHS Alliance can be contacted via j.wood@nhsalliance.org.
2. The 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.