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One in 10 CCG’s ‘failing or at risk’ as NAO calls for long-term plan to deliver ‘stability’ in restructure

A review from the National Audit Office (NAO) has revealed that many NHS CCGs are failing to function effectively, hire or retain staff, or operate within their budgets.

Five years after the former health secretary Andrew Lansley’s overhaul of the health service, auditors found that more than one in 10 CCGs are failing or at risk of failing.

CCGs were established in 2012 to help health services become more responsive to patient needs and to align clinical and financial decision-making. However, as of October 2018, 24 of 207 CCGs in England were subject to enforced recovery plans from NHS England due to poor performance or financial management.

Over 40% of CCGs were rated as either ‘requires improvement’ or ‘inadequate’ in 2017-18, whilst 75 of the CCGs overspent their budgets by a whopping £213m collectively, the NAO found.

Auditors found that CCGs were also facing major issues hiring and retaining the high-quality staff they need, and have “struggled to attract or retain high-quality leadership.”

With the structure of CCGs “evolving” with mergers, shared management teams, and increasingly joint working, changes are intended to help with planning and integrating services. However, the NAO warned there was a risk that working across greater populations would lead more CCGs to struggle to meet patients’ needs.

Amyas Morse, the head of the NAO, said: “We have seen almost three decades of change to NHS commissioning. It would be a huge waste if in five years’ time NHS commissioning is undergoing yet another cycle of reorganisation resulting in significant upheaval.

“The current restructuring of CCGs must deliver balanced and effective organisations that can support the long-term aims of the NHS and deliver a much-needed prolonged period of stability.”

NHS England is expected to set out its vision for commissioning in its long-term plan for the NHS in January 2019, after it was delayed this week, and has said it will step in where CCGs diverge from its vision of effective commissioning.

Image credit - Peter Byrne/PA Wire/PA Images

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