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NHS Commissioning Board to have the power to stipulate CCG staff

05/04/12

Draft authorisation to be discussed this month has alleged that the NHS Commissioning Board could decide the types of staff CCGs should employ.

In the document, it details the four application waves the CCGs can take part in before becoming fully authorised, also with the six criteria all bodies are expected to fulfil before being handed over control from the PCTs.

The authorisation criteria are:

  1. A strong clinical and multi-professional focus which brings real added value.

  2. Meaningful engagement with patients, carers and their communities.

  3. Clear and credible plans, which continue to deliver the Quality, Innovation, Productivity and Prevention (QIPP) challenge within financial resources, in line with national requirements (including excellent outcomes) and local joint health and wellbeing strategies.

  4. Proper constitutional and governance arrangements, with the capacity and capability to deliver all their duties and responsibilities including financial control, as well as effectively commissioning all the services for which they are responsible.

  5. Collaborative arrangements for commissioning with other CCGs, local authorities and the NCB as well as the appropriate commissioning support.

  6. Great leaders who individually and collectively can make a real difference.

CCGs have a year to complete the process, as they are expected to complete authorisation by April 2013. There may be cases were CCGs are authorised with various conditions, as the guidance says:

“If a CCG has some significant areas where it does not meet the criteria the NCB may assess the CCG needs temporary additional support to develop and deliver. The NCB sector will determine the most effective source of support which might include putting specific management support in the CCG, the option of placing a representative on the CCG governing body for oversight, and assurance or temporarily ‘junior partner’ status in collaborative commissioning arrangements may be agreed where necessary. The NCB could make full alternative arrangements for the commissioning of some services”

National director of commissioning developed at the NHS Commissioning Board, Dame Barbara Hakin spoke to GP and said that when CCGs do become fully authorised, they would enjoy various freedom, and any conditions would most likely have a time limit imposed. This could mean that neighbouring CCGs could initially commission services if that CCG had restrictions.

“CCGs are brand new organisations. We can’t be in a position where we expect them to be brilliant from day one, although they are on the right track to become really good.

“I firmly believe that you can’t run organisations from outside. If you have three CCGs in a city and have a couple of main providers, quite often this might already have begun.

“If you have a really advanced CCG and one much less able, you might see for the moment that the more mature one leads with that provider.”

She also said that it would only be in exceptional circumstances that the NCB would tell a CCG who to employ, for example, if a group of commissioners were in financial trouble.

Tasks which the CCG could undertake to help them with the authorisation process have been drawn up, including 12 examples where its intervention has improved patient services.

The draft guidance is set to be discussed at a meeting of the NCB in Leeds on 13 April 2012.