The report of the first CCG and commissioning support service (CSS) scenario workshop has been published on the NHS Commissioning Board Authority’s website.

Steering or Rowing? Report from a simulation event which tested how CCGs might utilise CSSs

The event, which was run in partnership with NHS Clinical Commissioners, and organised by the Health Services Management Centre at the University of Birmingham, involved more than 40 leaders from CCGs, CSSs and the independent sector.

Its aim was to explore the relationships between CCGs and CSSs, and to anticipate some of the likely challenges for CCGs and CSSs so that the NHS Commissioning Board Authority (NHS CBA) and partners can focus developmental activities effectively in the coming months.

Dame Barbara Hakin, National Director of Commissioning Development, said:  “CCGs and CSUs are developing in tandem, and thanks to their hard work they are on track to meet key milestones in the establishment of the new clinical commissioning system.

“There is still a great deal of work to do to ensure that clinical commissioners have all the support they need and we have used the insights from this report to inform the next phase of the NHS Commissioning  Board Authority’s programme of practical, targeted CCG and CSU development support over the coming months.”

Key insights from the event include:

• The customer /supplier relationship between CCGs and CSSs should be actively explored and tested in the workplace, until an acceptable balance is achieved which produces the best results for both parties.
• Whilst the subject of leadership is complex and situational (i.e. different styles are more effective in different situations) the prevailing commentary currently is that distributive leadership is the preferred style to operate successfully in a localised, flexible system without a designated system manager. New leaders and new organisations may benefit from leadership development to adapt their styles and hone their skills.
• Organisations within the system will need to learn when and how to take up authority, and when to allow others to lead. This requires sophisticated relationships, processes and leadership behaviours in order to succeed, and this is as much a requirement  for CSSs as  CCGs, as they develop their organisational forms and function.
• CCGs will need to use CSSs to free themselves up from the detailed operational issues in order for them to focus on system and strategic issues.
• The clinical leader’s role needs to be well supported by other commissioning team members and their expertise recognised and used effectively.
• The vital role of the wider multi-disciplinary team in offering expert advice and support to the commissioning process needs to be considered in practice by CCGs
• Prospective CCGs should draw on the national work framing the unique contribution of clinicians to commissioning to help focus how they use clinical time.

The Board Authority is using the insights from the report to inform its approach to CCG and commissioning support development over the coming months, and is providing a programme of targeted, practical support to CCGs and CSSs including:

• Guidance for CCGs and CSUs on collaborative commissioning arrangements.
• Guidance for CCGs on procuring clinical services.
• Exploring with CCGs the potential procurement options for buying commissioning support. The draft mandate to the NHS Commissioning Board – Our NHS Care Objectives, which is currently subject to consultation – outlines that the NHS CB will need to set up a new procurement framework to enable CCGs to procure from providers.
• A market development group that includes representatives from local authorities and the independent sector to develop a long term market development strategy for commissioning support. As part of this workstream, there will be a series of ‘market days’ for CCGs later in 2012. These will support CCGs to become more informed customers of commissioning support.