News

Another 52 CCGs authorised to commission GP services

NHS England has authorised another 52 CCGs to take on delegated responsibility for commissioning GP services in an effort to improve out-of-hospital services.

The CCGs will be able to operate under the new arrangements from April 2016 – meaning that by 2016-17, about half of all CCGs will have delegated responsibility.

‘Delegated responsibility’ is one of the three models offered to CCGs, along with ‘joint commissioning with NHS England’ and ‘greater involvement in commissioning’.

Dr Amanda Doyle, primary care co-commissioning programme oversight group co-chair and chief clinical officer for NHS Blackpool CCG, said it was good news that 50% of all CCGs will be operating under delegated arrangements: “It shows ambition and enthusiasm to take the lead in changing the way care is delivered.”

“If we are to truly transform out of hospital care and build primary care that will be sustainable for the future, CCGs must have the commissioning levers, as well as the resources, to succeed for their patients and local populations,” she added.

The new commissioning powers will support the development of new models of care and should provide more opportunities to develop commissioning based on improved local health outcomes.

The first 64 CCGs were authorised to take delegated responsibility in February of this year, with another 87 approved in March to take on joint commissioning.

Ian Dodge, national director for commissioning strategy at NHS England, said the announcement was part of a wider strategy to achieve placed-based commissioning.

“CCGs are increasingly wanting to join up the commissioning of general practice with other community services in order to develop more integrated care for their communities and patients,” he said.

“Provided that conflicts of interest are managed robustly and properly, we are learning that the delegated model looks most likely to deliver the greatest benefits.”

But CCGs have proven time and again that the challenge lies exactly in managing these conflicts of interest. Just last month, an investigation by the BMJ and the Times found that CCGs awarded nearly 500 contracts worth at least £2.4bn to providers in which one or more of their board members had a financial interest.

The probe confirmed an earlier investigation by NHE that revealed nearly one-fifth of CCGs have required more than half of their board members to withdraw from a meeting because of conflicts of interest.

But even if some GP members leave board meetings at times, NHS England’s current rules on conflicts of interest are relatively loose, with the BMA’s GP committee chair dubbing it “too permissive”.