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05.09.14

Call for single health and care commissioning opposed by CCGs

Clinical Commissioning Groups (CCGs) have hit out at yesterday’s Barker Commission recommendation to establish single commissioning for health and social care, perhaps using a variant on the health and wellbeing board model. 

Responding to the report, Dr Steve Kell, co-chair of NHS Clinical Commissioners, said this move would represent another “top-down reorganisation” and would put at risk “essential clinical leadership we have seen develop as a result of clinical commissioning”. 

His statement reiterates the views he expressed at this year’s NHS Confed when health minister Norman Lamb MP backed the idea of a single pooled budget for health and care in every local area, along with joint commissioning of both. 

Following the release of Dame Kate Barker’s report – A new settlement for health and social care – Dr Kell added that CCGs are starting to address many of the issues around fragmented commissioning. 

He added: “They are working in partnership to develop local solutions for their populations. Local authorities and the NHS are increasingly working together, and we must allow this relationship to develop.” 

However, Dr Kell stated that there needs to be time given to develop an approach where each commissioner and provider has joint responsibility for their health economy and the outcomes for their population, and where each is accountable to the others for their decisions and performance. 

NHS Clinical Commissioners also noted that while health and wellbeing boards are an important part of the new system, they are not commissioning bodies and are not ready to take on new responsibilities. 

The Barker Commission also recommended an end to free NHS Continuing Healthcare by incorporating it into the wider social care system, and radical changes to prescription payments include reducing charges, currently £8.05 per item, to as low as £2.50 – but significantly cutting the number of prescriptions exempt from charges, to raise £1bn a year. More on its funding recommendations here

But the Royal Pharmaceutical Society said ‘taxing health based on wealth’ is “just plain wrong”. The Society’s English Pharmacy Board chair David Branford said: “The proposal to make everyone pay a £2.50 prescription charge for each medicine merely extends this tax on health to everyone and heaps unfairness on top of illness.” 

He added that there’s lots of evidence to show that prescription charges lead to individuals being selective about which medicines they purchase leading to inadequate treatment, worsening health and expensive hospital admission. 

(Image of Dr Steve Kell c. NHS Confederation) 

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