Half of all the new GP-led groups will begin commissioning healthcare on behalf of their local communities on April 1 with a clean bill of health and no requirement of on-going national support.
Every community in England is now covered by one of 211 Clinical Commissioning Groups (CCGs), which will be led by GPs and will plan and commission hospital, community health and mental health services on behalf of their local areas. Together, CCGs will be responsible for £65 billion of the £95 billion NHS commissioning budget.
They were authorised by NHS England (formerly the NHS Commissioning Board) to take on their functions, following a rigorous assessment process, in four “waves”. Groups of CCGs were authorised in December, January, February and March.
NHS England’s Authorisation Sub-Committee has now reviewed the progress made by CCGs in the first three waves of authorisation. This has resulted in 63 CCGs formally discharging all conditions on their authorisation, bringing the total of fully authorised CCGs to 106
A further 47 CCGs have formally discharged some of their conditions, while two have had legal directions lifted from their authorisation. Of those CCGs with remaining conditions, the majority (55 out of 105) have fewer than five conditions.
14 CCGs are authorised with legal directions, meaning their conditions are underpinned by legally-mandated support from NHS England or another CCG.
Dame Barbara Hakin, National Director for Commissioning Development at NHS England, said: “I am delighted that more than three quarters of CCGs will begin work with either full authorisation, or with only a small number of conditions. Local clinicians are enthusiastic about the opportunity to shape healthcare on behalf of their local communities, and that enthusiasm has shone through during the authorisation process.
“As we have always anticipated, CCGs are at differing levels of maturity, so some do need intensive support, while others are already well advanced. NHS England is fully committed to providing collaborative help and support for all CCGs.”
CCG leaders have worked hard over the past year to establish their organisations and set out robust plans and strategies for healthcare in their areas. NHS England has an on-going responsibility to support CCGs, and will continue to review conditions regularly, ensuring robust support and oversight is provided to those CCGs that still have work to do but removing conditions once CCGs have demonstrated progress.
This oversight extends to provision of new and additional support: the conditions review process has also resulted in a legal direction being added to one CCG’s authorisation, and to some conditions being upgraded from level II to level III, meaning the CCG must receive additional sign-off from NHS England for some areas of its work.
Dame Barbara said: “NHS England will work with CCGs to help them identify areas where improvement is needed, and to help them make those improvements. We will publish the CCG assurance framework shortly, and we are working with CCGs to finalise procedures to be followed if there are concerns about any CCG’s ability to ensure quality and delivery today or transform services for the future.
“Thanks to the dedication shown by the leaders of CCGs all over England, most have established themselves extremely well, and all will continue to develop and mature over the coming months and years. It is vital that they are as robust and capable as possible, with appropriate support where improvement is needed, as they are set to take on great responsibilities, controlling the lion’s share of the NHS commissioning budget.
“These organisations are pioneers, and we have all learned much from their establishment. Though many CCGs have developed excellent commissioning plans and governance arrangements, and recruited highly-experienced governing body members, some continue to need support in these areas. The NHS CB is working closely with these CCGs, and further insight from the authorisation process will be used to inform local and national planning for future years.”