Bulletin for CCGs: Issue 37, 11 July 2013


Strategic issues:

Operational issues:

Other news:

Events and campaigns:


Gateway reference number: 00242

Download the Bulletin for CCGs: Issue 37, 11 July 2013 (PDF, 140KB)


Welcome from Dame Barbara Hakin

Dame Barbara Hakin Interim Chief Operating Officer and Deputy Chief Execetive

Dame Barbara Hakin
Interim Chief Operating Officer and Deputy Chief Executive

Welcome to the latest edition of the Bulletin for CCGs. It has been a few weeks since the last edition and it felt a pertinent time since the Comprehensive Spending Review announcement on 26 June 2013 which will have a major impact on the way we plan and deliver services. I know from speaking to many of you that this is at the top of your list of priorities. Paul Baumann, Chief Financial Officer, wrote to area team directors following the announcement (see Letters) to explain what this means in real terms. You should have already received a letter from your area team to explain this.

Given this announcement, we are all acutely aware that these are very challenging times for the NHS both financially and structurally. In NHS England’s business plan, Putting Patients First, we made a commitment to a large scale engagement on how it will deliver NHS services in the future. Today, Sir David Nicholson launched a document setting out a case for why we need to change the way services are delivered called ‘The NHS belongs to the people: a call to action’. I know that members of the Commissioning Assembly have provided views and input to this, which has been very valuable.

The call to action is a major piece of public engagement – both nationally and locally – which will be happen in three phases, with the depth and detail of the call to action increasing at each phase. All three phases will happen at CCG level and will be supplemented with regional and national events over time. To start with the call to action is being digitally led through NHS Choices. Your area team and CSU will work with you to engage with your local communities to drive this forward giving everyone the opportunity to input.

NHS England has been running a number of engagement events for CCGs to build on the development support both regionally and nationally (see Events). These events have also given attendees the opportunity to input into the CCG assurance framework. A draft version of this was published in April 2013, but there is a further opportunity to feed into this framework by taking part in a survey launched today. I would urge you to complete the survey as this a truly collaborative document and your input is crucial so that we publish a framework that works for all stakeholders. The final document will be published in Autumn 2013.

The draft CCG development framework is tabled for discussion at the next NHS England Board meeting on 18 July 2013 and is an important milestone. More detail and a link to the Board papers can be found later in the Bulletin.

Finally, at the Leadership Forum today, NHS England launched a description of the ways of working that we want to create when working together with CCGs. These ways of working have been developed collaboratively by NHS Clinical Commissioners and colleagues in NHS England, and have taken into account the views across this important relationship between NHS England and CCGs. You will see more information on this in the Bulletin.

Dame Barbara Hakin
Interim Chief Operating Officer and Deputy Chief Executive


Strategic issues:


1. Updates from NHS Commissioning Assembly Working Groups

Election of a Clinical Co-Chair and Deputy Clinical Co-Chair for the NHS Commissioning Assembly CCG Development Working Group

Dr Nadim Fazlani, Clinical Chair, Liverpool CCG has been elected by CCG leaders to become clinical co-chair of the NHS Commissioning Assembly CCG Development Working Group and Dr Graham Jackson, Clinical Leader and Chair, Aylesbury Vale CCG (Buckinghamshire) has agreed to act as deputy clinical co-chair. We are really fortunate to have the support of both in helping us shape and deliver a really meaningful development offer for CCGs together.

The group is looking to extend its membership so that it involves a full range of CCGs based on both geography and development needs. The next meeting of NHS Commissioning Assembly CCG Development Working Group is on Thursday 11 July 2013.

  • To express an interest in joining the group, to find out more about its work, or for further information about other opportunities to be engaged in the work of developing CCGs, please contact Annabelle Walker, Head of CCG Development.

Health Inequalities Working Group

Health inequalities is an issue of Social Justice.

NHS England, CCGs, Public Health England and other bodies have a crucial role to play in this area and a legal duty ‘to reduce health inequalities between patients with their ability to access services and reduce health inequalities between patients with respect to outcomes achieved for them by the provision of health services’.

While ‘integration’ seems to be on everyone’s, lips most people are unaware that under the Health and Social Care Act 2012, each CCG ‘must exercise its functions with a view to securing health services are provided in an integrated way where… it will improve quality and reduce inequalities in access and outcomes’.

A new working group of the Commissioning Assembly is to be set up under the co-chairmanship of Dr Sam Everington, Chair of Tower Hamlets CCG in east London and Professor Steve Field, Deputy National Medical Director – Health Inequalities, NHS England.

We are now seeking CCG colleagues to join the working group to help shape and take forward this important policy area. We are aware that there are a number of CCGs who are undertaking some innovative work to tackle health inequalities and it would be good to hear from you and to share this good practice with colleagues.

Armed Forces Clinical Reference Group seeks new recruits

NHS England has launched recruitment to the latest addition to its Clinical Reference Group (CRG) structure. The Armed Forces CRG will provide clinical advice to NHS England in support of its role in commissioning some services for serving armed forces personnel, their families, mobilised reservists and veterans.

NHS Commissioning Assembly Event – 25 September 2013 – Edgbaston Cricket Ground

We are pleased to announce that 2013 NHS Commissioning Assembly event for CCG leaders on 25 September will be held at Edgbaston Cricket Ground in Birmingham. Please put the date and venue in your diary. Further details will follow including accommodation options.

The event is a key opportunity for all Assembly members from across England to get together, share experiences and continue to build the common purpose of our ‘one team’, as well as setting the direction of travel for the months ahead.

A detailed programme for the event is being developed by a design group which includes CCG clinical leaders and members of NHS England. We have listened to what worked well from last year’s event and fed this into these discussions, we will continue to work with you to ensure the design of the event meets your needs.

  • If you would like to comment on the design of the Commissioning Assembly event please contact Bethany Clift.


2.    The NHS belongs to the people: a call to action

An important engagement exercise on the future of NHS services with ambitions to capture a wide range of feedback has been launched by NHS England. ‘The NHS belongs to the people: a call to action’ sets out the current position of the NHS and describes the challenges facing it such as restricted funding, a growing older population and rising expectations of the NHS should do. It then goes on to identify some of the opportunities available to the NHS to make a difference in the way services are delivered while continually improving the quality of care patients receive.

The call to action encourages everyone: patients, the public and staff to start talking about these challenges and to identify ways they can be solved, often at a local level. Much of the call to action will take place in CCGs and will give staff the opportunity to explain what’s behind local commissioning decisions.

To start with the call to action will mainly take place on NHS Choices. The feedback from the first few months will help design more precise engagement events at CCG, regional and national levels.

After discussions at the Assembly Steering Group meeting on 9 July 2013, Peter Melton, Chair of the NHS Commissioning Assembly Steering Group wrote to the CCG Assembly members on ‘A Call to Action – Local Leadership and Engagement’. Peter’s letter can be found in the ‘Letters’ section.


3.    NHS England’s ‘ways of working’ with CCGs launched

NHS England and NHS Clinical Commissioners (NHSCC), as the independent collective voice of CCGs and its representative body, have been working together to co-produce ways of working that support CCGs and NHS England. The ways of working flow from NHS England’s vision and purpose and are integral to the way NHS England works.

NHS England has multi-faceted roles in relation to the new commissioning sector with prime importance being assurance, support and development of, and co-commissioning with, CCGs. In order to achieve the best outcomes for patients in England how key partners work together will be crucial.

An independent survey will be undertaken by NHSCC in October 2013 to understand the extent to which these ways of working are being realised. It will ask all CCGs to assess how far NHS England is modelling the ways of working in practice, in all its relationships with CCGs, across all its roles. NHS England will also reflect on its ways of working with CCGs in light of the survey results.

The outcomes will be shared with all CCGs and with NHS England in Autumn 2013.


4.    Influencing the CCG Assurance Framework online

In May 2013, NHS England published the ‘CCG Assurance Framework (outline proposals and interim arrangements)’. This document, tested early on with some CCG leaders, represents NHS England’s initial proposal for how CCG assurance will be undertaken.

Through this framework, we want to assure that CCGs are working to improve services and quality of care for patients, as well as realising their full potential in becoming ‘great’ CCGs and getting the best possible outcomes for their local populations.

The CCG Assurance team have created an online option for you to use to help you give your views. It is a simple, structured way of providing feedback on the proposals contained in the document. It has been designed to allow you to answer each of the questions in turn or, if you prefer, just to focus on the area(s) that are of particular concern to you.

We will use this feedback in the development and construction of the final CCG Assurance Framework to be issued in autumn 2013. We strongly encourage all those with an interest in the CCG assurance process to take the opportunity to provide your views and we look forward to hearing from you.

  • Please read the draft framework before you comment
  • You can see the questions and give your feedback here
  • Closing date is Monday 5 August 2013.


5.    Draft CCG Development Framework goes to NHS England’s Board meeting

Putting Patients First: The NHS England business plan for 2013/14 – 2015/16 sets out the operating model for NHS England with eight key activities described. The first of these activities is “supporting, developing and assuring the commissioning system.” The draft CCG Development Framework describes how NHS England will meet the first two parts of this commitment, in relation to CCGs.

The draft CCG Development Framework has been co-produced with CCGs, and sets out the most important areas for future development if CCGs are to succeed in securing great outcomes and leading transformation.

Through this, it will provide a framework for CCGs and area teams to identify where to prioritise development efforts – “locally determined, nationally enabled” – and signals to national partners and suppliers where they can effectively add value. The draft CCG Development Framework approach will be discussed at NHS England’s Board meeting on 18 July 2013.


6.    How do you want to choose your commissioning support?

In June 2013, NHS England set out how it was going to support the development of a vibrant market for commissioning support services where CCGs are able to choose the best service for them.

We are committed to working with CCGs and other key stakeholders over the summer to look at how we can support CCGs to choose and buy their commissioning support through simple and cost effective procurement routes. We also said that we would need to look at the timetable and how we can support CCGs to exercise choice without destabilising support services for other commissioners nor risk losing the important focus on forthcoming contracting rounds.

We want to hear your views on the proposed options and where we should focus our efforts and have set up a short survey where you can feed in your thoughts. It should take less than 10 minutes to complete and can be found here.

  • The deadline for feedback and comments is Friday 16 August 2013.

We have also set up a webinar on Wednesday 31 July at 1.15pm-2.15pm, where we hope to have a more in-depth discussion with CCGs around the proposals. If you would like to attend, email and we will send you the joining instructions.


7.    Review of incentives, rewards and sanctions / Review of the NHS Standard Contract for 2014/15

NHS England has launched two interlinked engagement processes aimed at gauging the views of stakeholders on two key issues:

  • Everyone Counts: Planning for Patients 2013/14 set out a commitment to undertake a fundamental review of incentives, rewards and sanctions. This review is now getting under way, with involvement from the Commissioning Assembly Working Group on incentives. A discussion document, setting out specific issues and questions on which NHS England would welcome feedback here.
  • Please send your feedback to:
  • NHS England is also beginning the process of reviewing the NHS Standard Contract for 2014/15. The Standard Contracts is intended to be used by commissioners for all contracts for clinical services other than primary care. Again, a discussion document setting out specific issues and questions on which NHS England would welcome feedback is available here.
  • Please send your feedback to:

Please follow the weblinks above for access to the discussion papers and for details of how to let us know your views.

  • The deadline for feedback for each topic is Friday 2 August 2013.


Operational issues:


8.    Funding transfer from NHS England to social care – 2013/14

For the 2013/14 financial year, NHS England will transfer £859 million from the Mandate to local authorities to support adult social care. The amounts to be paid to individual local authorities from the area teams are set out at Annex A. It should be noted that the funding will be administered by the respective area teams and not CCGs.

The funding must be used to support adult social care services in each local authority, which also has a health benefit. Health and wellbeing boards will be the forum for discussions between the area teams, CCGs and local authorities on how the funding should be spent and the outcomes expected from this investment.


9.    Variations to NHS Standard Contracts

NHS England has published technical guidance on the process through which commissioners can effect local variations to their commissioning contracts.

The guidance includes links to the template Variation Proposal and Variation Agreement. The variation process does not, of course, allow commissioners to vary locally the national mandated terms and conditions of the NHS Standard Contract.


10. Assessment centres available for CCG chairs and accountable officers

For 13/14, new CCG chairs and accountable officers continue to have the opportunity to attend an individual assessment and development centre provided by The Hay Group. Future nominations should be agreed with area team directors.

  • For more information contact Annabelle Walker, Head of CCG Development, NHS England


Other news:


11. Draft governance code for CCGs

Recognising the governance challenges facing CCGs as they become established, the Institute of Chartered Secretaries and Administrators (ICSA) has created a draft governance code to support clinicians in developing good governance arrangements, and to help build and maintain public trust in CCGs and the NHS as a whole.

ICSA has worked with an expert panel, chaired by Lord Hunt of Wirral (Chair of the Press Complaints Commission and the Lending Standard Board) who was formerly a regulatory law specialist from DAC Beachcroft, to shape the draft code. The panel represents all the specialities required within the governing body of a CCG and draws upon their experience of the NHS and effective governance.

To make sure the draft code is as practical and relevant as possible, ICSA is now seeking feedback through an expert review process from those working in the NHS and those with considerable knowledge of its governance challenges. ICSA’s aim is to produce a final code that has been developed for the health service by the health service, and CCGs’ input will be central to this.

If you would like to respond and give your feedback, you can do so in a variety of ways:

Online: Take part in the expert review

Webinars: If you would prefer to join the debate, ICSA is running webinars. The next event is on 18 July, 13.45 – 14.30 – Book now.

Writing: Alternatively you can email your comments or post them to: CCG Code Feedback, ICSA Policy Department, 16 Park Crescent, London, W1B 1AH.

  • The deadline for feedback is Friday 26 July 2013.


12. Personal Health Budgets – the pilot is over and they’re coming your way!

All CCGs will soon need to be able to make personal health budgets available. From April 2014 everyone eligible for NHS Continuing Healthcare funding will have a right to ask for one.

Support is available to help CCGs manage the change, via a free NHS programme. This builds on best practice and other information developed during the pilot programme and learning from early adopter sites and includes training programmes, self-assessment tools and all the latest guidance.

To benefit from the programme, CCGs should register via the personal health budgets website where they can also find out more about this major transformation in delivering healthcare locally.

  • To understand the impact and ensure you are ready, please register by Friday 16 August 2013.


13. Making a local difference – state of play and challenges ahead for health and wellbeing boards

A report from the NHS Confederation, in partnership with the Department of Health and the Local Government Association examines the progress made by health and wellbeing boards towards effecting real improvements in health outcomes in their local area. It also identifies five major learning opportunities from their ‘shadow period’, shines light on future challenges the boards are likely to face, and highlights good practice case studies and other resources that are available to help boards as they tackle these challenges.


14. The Department of Health’s Health and Social Care Volunteering Fund (HSCVF) has launched its fourth local grant and capacity building scheme

The local grant scheme 2012 funded 37 projects across England. The HSCVF local grant and capacity building scheme has been designed to improve the voluntary sector’s potential in the health, public health and social care landscape by helping them to become more sustainable. The HSCVF differs from many other grant funding schemes as it aims to help organisations grow and develop, not just provide a short term input of grant monies. This is why the funding offer for all successful applicants includes both the tailored capacity building support package which aims to build organisational capacity that will assist with longer term sustainability and grant monies to develop volunteer-led service delivery through a discrete project.

  • Find out more about the scheme can make a difference to local voluntary sector organisations
  • Follow HSCVF on Twitter @HSCVF
  • Find out more about HSCVF on YouTube


15. Making the link between health and housing

The Housing Learning and Improvement Network, formerly part of the Care Service Improvement Partnership at the Department of Health, have developed a useful web resource that makes the connection between health and housing on a set of core themes which may be of help those working on older people services in the NHS. They range from a broad look at health and housing policy to more focussed topics covering integration: health and housing partnerships; the link with hospital and care pathways; supporting prevention and re-ablement services, public health and housing; housing and long term conditions management; and NHS estate and asset management.


16. NHS Library and Knowledge Services – working in partnership with commissioners

Library and Knowledge Services (LKS) are an integral part of the core business of the NHS. They enable staff to have the relevant skills and knowledge to make evidence based decisions, resulting in excellent patient care. LKS offer a unique service to commissioners that complement and build on the work of other commissioning support units (CSUs) to provide comprehensive business intelligence.

Services add value by:

  • searching and gathering evidence on the topics of your choice
  • developing bulletins and alerts to keep you up to date with new research guidelines, best practice and policies
  • tracing and supplying specific publications you request
  • assisting staff in their professional and personal development through study skills, a dedicated learning environment and supplying texts.

What to do next:

Step 1: Contact your local LKS – search online to find your nearest service

Step 2: Sign up for an NHS Athens account – use your NHS Athens account to access a wide variety of electronic resource.

Step 3: Search for national, regional and local electronic content at NICE Evidence Services and on the Healthcare Databases Advanced Search pages.

Step 4: For bespoke services please contact your regional LKS Lead


17. New vaccine offers babies protection against rotavirus

Infants are now being offered protection against rotavirus as part of the routine NHS childhood immunisation programme. Rotavirus infection is the main cause of diarrhoea in the under 5’s each year and leads to hospital stays for nearly 1 in 10 (around 13,000) of those who get it. The new vaccine, available from 1 July 2013, is expected to halve the number of diarrhoea and vomiting cases caused by rotavirus and lead to 70 per cent fewer hospital stays. This is the first of a number of planned improvements to the national immunisation programme that are due to be implemented this year.


18. Call for evidence on general practice services sector in England

Monitor has issued a call for evidence to determine the extent to which commissioning and provision of general practice services is operating in the best interests of patients. Monitor will publish issues statement and next steps (if any) by the end of 2013.

  • Find out more from Monitor
  • Any party that wishes to submit their written views, feedback, evidence or that has any queries in relation to this work, please email by 1 August 2013, or write to GP services Call for Evidence, Monitor, 133-155 Waterloo Road, London, SE1 8UG


19. Public Health England publishes new commissioning guidance for treatment for dependence on prescription and over-the-counter medicines

New commissioning guidance for the NHS and local authorities on how to respond to the needs of people who are addicted to prescription and over-the-counter medicines has been published by Public Health England (PHE). The purpose of the guide is to support commissioners in providing an appropriate response to the problem based on a full assessment of local need.

Earlier this year, commissioners and providers of drug treatment services came together to discuss commissioning arrangements for addiction to medicines, at an event organised by the former National Treatment Agency (now part of Public Health England). The drive to improve local service provision is supported by Anna Soubry, Parliamentary Under-Secretary for Public Health.

The new guidance has been produced with input from experts on addiction to medicines. It outlines a number of sources that commissioners can use to identify the scale of misuse or dependence, and in relation to what medicines, in their area. It emphasises that all these checks – such as finding out about GP prescribing patterns, and speaking to those with first-hand experience of addiction to medicines – are important to understand fully what services are needed.


Events and campaigns:


20. National Institute for Health Research Health Technology Assessment conference, 9-10 October 2013, London

The National Institute for Health Research Health Technology Assessment (HTA) programme funds research on behalf of NICE and health policy makers. NHS leaders, commissioners and decision makers are invited to attend a conference on 9-10 October 2013 looking at the impact of HTA research and how it influences the NHS.


21. CCG development events

A number of recent national events has seen CCG leaders and colleagues from NHS England regional and area teams working together to provide a stronger insight into emerging CCG development needs, highlight the development support already on offer locally and nationally, and enabled collaborative working on the proposal for annual CCG assurance.

These events are part of a series of five and places are still available at the following two events via the appropriate link below:

As ever, your support and input into these events will be key to our shared success moving forward.

The feedback and improvement suggestions for CCG annual assurance will be used to develop the draft proposal or “strawman” which will be finalised at a national assurance summit to be held at the Hallam Conference Centre, London, on Wednesday 24 July.

This summit will focus on working together through all outstanding issues flagged at the previous five events with the aim of agreeing a final version of the proposal.

  • Register your interest for the event.
  • For any general queries, please contact Julia Simon, Head of CCG Strategic Support, NHS England.
  • Join the conversation around the events on Twitter using #ccgdev.


22. Have your say – Urgent and Emergency Care Review stakeholder engagement event

Professor Sir Bruce Keogh’s Urgent and Emergency Care Review was announced in January this year. Its aim is to develop a national framework to build a safe, more efficient system, 24 hours a day, seven days a week. The Review has developed an evidence base for improving urgent and emergency care, emerging principles on how a future system might be shaped, objectives which the new system would seek to achieve, and possible implementation options.

A stakeholder event to help shape the future of urgent and emergency care in England is also taking place on Tuesday 6 August from 9.30am to 1.30pm, Thistle Marble Arch, London. This will provide the opportunity for delegates to contribute and comment on the Review’s evidence base and emerging principles. GPs who would like to attend can register for a free place by clicking on the link below.

The event takes place during the period of engagement (17 June to 11 August 2013) which seeks views from NHS staff, patients and members of the public through the online questionnaire.


23. Do you know someone who goes above and beyond their role to make a difference?

The NHS Leadership Recognition Awards launched regionally on Monday 3 June 2013 and will celebrate leaders at all levels and across all professions who have ultimately improved people’s health, the public’s experience of the NHS and those leaders who we are truly proud to work alongside.

90 winners from across the country will then be in with a chance to win the following National Awards in February 2014.




24. A call to action – local leadership and engagement

Peter Melton, Chair of the NHS Commissioning Assembly Steering Group wrote to CCG Commissioning Assembly members on ‘A Call to Action – Local Leadership and Engagement’ following discussions at the Assembly Steering Group meeting held on 9 July 2013.

25. Spending Review briefing

Paul Baumann, Chief Financial Officer, wrote to area team directors following the Spending Review announcements on 26 June 2013 asking them to brief CCGs in their areas, and attached a template to facilitate this.


About this bulletin:


Access the bulletin online.


Please do forward this bulletin to colleagues and encourage them to sign up online.


If you have an idea for a future issue, please email the CCG bulletin mailbox.

Future communications to CCGs

We have had feedback from a number of CCGs about preferred methods for communications. We will be putting in place a more systematic methodology to reach all CCGs directly. If you have any comments you would like to make on this, or indeed on the bulletin, please email the CCG bulletin mailbox.

Categories: Bulletin for CCGsHome