Final authorisation decision-making process set out

The CCG authorisation governance process is set to be finalised at the NHS Commissioning Board Authority’s meeting in Newcastle on 20 September. A paper seeks the approval of the Board to further proposals on how the moderation, conditions and decision elements of the CCG authorisation process will operate.

A key proposal is to share the recommendations of the Conditions Panel with the CCG prior to decisions being made by the CCG Authorisation Sub-Committee of the NHS CB. The proposal, which has been developed in response to CCG feedback, means CCGs will have two weeks to comment and provide any new evidence that may remove the need for a specific condition.

If approved, it means the final authorisation decision by the CCG Authorisation Sub-Committee of the NHS CB will be four to five weeks later for each wave, and that first decisions on CCG authorisation are due in early December 2012.

The paper also proposes the membership and terms of reference for:

  • The Moderation Panel, chaired by National Director: Commissioning Development Dame Barbara Hakin, will meet once a month from October 2012 to January 2013, and will ensure overall consistency and make recommendations as to whether a CCG should be fully authorised or authorised with conditions.
  • The Conditions Panel, chaired by Deputy Chief Executive and Chief Operating Officer Ian Dalton, will meet fortnightly from November, and will consider what support is required where a CCG has not supplied sufficient evidence to meet a threshold for one or more authorisation criteria. The output of the panel will be a report with the recommended conditions and support for each CCG. Regional directors would be given an opportunity to approve the recommendations made on conditions and support for each CCG being considered from their region prior to consideration by the Conditions Panel. They may choose to take informal soundings locally prior to the Conditions Panel on options where the panel is likely to consider that a CCG needs intensive support.
  • The CCG Authorisation Sub-committee will be chaired by an NHS CB non-executive director and will meet twice per wave between October 2012 and February 2013 to make authorisation decisions, and quarterly from March 2013 to consider the removal of conditions. The conclusions of each sub-committee meeting would be published immediately after each meeting, once decision letters have been issued to CCGs.

The Board paper, outlines in full how the moderation and conditions/support processes will work, and how decisions will be made by the NHS CB.

It proposes that a standard review date of March 2013 will be built into all conditions and that CCGs may submit evidence to the relevant regional office which will determine whether the condition can be removed for the majority of conditions. For the more substantial conditions, the sub-committee will need to sanction their removal.

Following the decisions of the Board on 20 September, a factsheet on the process will be prepared and circulated to CCGs.