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20.10.16

CCGs ‘here to stay’ but one model for local commissioning unlikely

CCGs should adopt new models of delivering services, but should not be subject to top-down reorganisations, NHS Clinical Commissioners (NHSCC) has said in a new paper on the future of the sector.

The ‘Future of Commissioning’ report says that CCGs are “here to stay” after they were introduced in the 2012 Health and Social Care Act, but that they are already undergoing a “CCG evolution” to deliver more patient-focused and integrated care as part of the Five Year Forward View.

The paper notes: “We do not believe there should be any further top-down reorganisation of the NHS, not least because the focus of the NHS at this time must be to achieve ongoing sustainability and deliver a transformed service fit for the 21st century.

“In fact, we fully expect a diversity of organisational types and relationships to emerge that are led from the bottom up and are truly place-based. We know from our members that there is no appetite for any further legislative change or restructuring of clinical commissioning. With a system heavily focused on financial sustainability and transformation, we strongly advocate a period of stability around the statutory functions of clinical commissioning.”

The paper said that in the future, there was “unlikely to be one model” of local commissioning. It said that CCGs could adopt other structures, such as accountable care organisations (ACOs), to deliver their statutory functions.

NHSCC said: “We see this less as a dismantling of the statutory commissioner task, rather much more the opportunity for CCGs to become strategic commissioners – taking a multiannual, place-based and outcomes-oriented perspective, with an emphasis on quality, oversight and evaluation.”

It also recommended CCGs working more closely together or even merging, leading to commissioning footprints becoming larger in some areas and smaller in others.

However, it said that whatever their size, CCGs should use the emergence of sustainability and transformation plans (STPs) to “become hubs for strategic, whole-system and place-based commissioning of services”.

Dr Graham Jackson, co-chair of NHSCC and clinical chair of Aylesbury Vale CCG, said: “CCGs have demonstrated over the past three and a half years a great ability to innovate and develop services, cognisant of a local population’s needs.

“This new paper sets out how clinical commissioning can evolve in a locally driven and defined way that will allow us to further meet the needs of the local patients and populations we serve.”

Dr Amanda Doyle, the other co-chair and chief clinical officer of Blackpool CCG, said: “As ‘The future of commissioning’ brings out, the unique value of CCGs is their combination of credible clinical leadership, expertise and knowledge of the communities they serve.

“This local dimension must not be lost. Collaboration is also key - only through developing effective place-based relationships can we hope to assure the long-term sustainability of the NHS.”

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