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First CCGs set take on commissioning of GP services

NHS England has approved the first set of GP-led Clinical Commissioning Groups (CCGs) that will take on responsibility for commissioning the majority of GP services from April this year.

*64 CCGs across the country have been approved to take on greater ‘delegated’ commissioning responsibility for GP services with the possibility that others may follow. This follows plans set out by NHS England Chief Executive Simon Stevens, early last year, to give patients, communities and clinicians more scope in deciding how local services are developed.

Dr Amanda Doyle, Primary Care Co-Commissioning Programme Oversight Group Co-Chair and Chief Clinical Officer for NHS Blackpool CCG said: “This is a journey to enable local commissioning arrangements that can deliver the kind of integrated care, in and out of hospital that we all want to see.

“Giving GP-led Clinical Commissioning Groups more influence over the wider NHS budget, will enable a shift in investment from acute to primary and community services and to enable money to follow the patient. The introduction of co-commissioning is another strong step on the path to provide a more joined up, high quality service for the future.”

Ian Dodge, National Director for Commissioning Strategy at NHS England, said: “Today we are backing 64 CCGs who have asked NHS England for full delegated powers to improve local primary care, within a transparent and robust framework for managing conflicts of interest. It is a vote of confidence in CCGs.  It is part of our commitment to deliver a new deal for primary care.  And it’s a critical step towards joining up the commissioning system, which in turn will help unlock new models of integrated care described in the NHS Five Year Forward View.”

Taking on ‘delegated’ responsibility from NHS England means CCGs will commission general medical services.

Delegated responsibility is one of three models offered to CCGs along with joint commissioning with NHS England and greater involvement in commissioning. Decisions on which CCGs will be approved for joint commissioning will be made in the coming weeks.

For CCGs that haven’t been approved at this stage, NHS England will continue to provide support to help them achieve the commissioning model that works best for them.

The latest move follows the plan set out in the Next steps towards primary care co-commissioning document developed by the joint CCG and NHS England primary care co-commissioning programme oversight group in partnership with NHS Clinical Commissioners, and is another step towards delivering the wider strategic agenda set out in the Five Year Forward View.

64 CCGs have been given full approval on their applications for delegation (see list below). One CCG is approved pending changes to some governance arrangements.

North

NHS Sunderland CCG
NHS North Durham CCG
NHS Durham Dales, Easington And Sedgefield CCG
NHS East Lancashire CCG
NHS Greater Preston CCG
NHS Chorley And South Ribble CCG
NHS Blackpool CCG
NHS Fylde & Wyre CCG
NHS Blackburn With Darwen CCG
NHS Bradford City CCG
NHS Bradford Districts CCG
NHS Calderdale CCG
NHS Wakefield CCG
NHS Scarborough And Ryedale CCG
NHS Harrogate And Rural District CCG
NHS Vale Of York CCG
NHS Barnsley CCG
NHS Rotherham CCG
NHS St Helens CCG
NHS Liverpool CCG
NHS Knowsley CCG
NHS Halton CCG
NHS Oldham CCG
NHS Wigan Borough CCG

Midlands and East

NHS South Warwickshire CCG
NHS South Worcestershire CCG
NHS Birmingham Crosscity CCG
NHS Sandwell And West Birmingham CCG
NHS Dudley CCG
NHS Birmingham South And Central CCG
NHS Telford & Wrekin CCG
NHS Shropshire CCG
NHS North Derbyshire CCG
NHS Hardwick CCG
NHS Mansfield & Ashfield CCG
NHS Newark & Sherwood CCG
NHS Nottingham North & East CCG
NHS Nottingham West CCG
NHS Nottingham City CCG
NHS Erewash CCG
NHS Rushcliffe CCG
NHS Southern Derbyshire CCG
NHS Lincolnshire West CCG
NHS Lincolnshire East CCG
NHS South West Lincolnshire CCG
NHS South Lincolnshire CCG
NHS East Leicestershire And Rutland CCG
NHS Leicester City CCG
NHS West Leicestershire CCG
NHS Castle Point And Rochford CCG

London

NHS Tower Hamlets CCG
NHS Waltham Forest CCG
NHS Newham CCG
NHS Redbridge CCG
NHS Barking & Dagenham CCG
NHS Havering CCG

South

NHS Eastbourne, Hailsham And Seaford CCG
NHS Hastings & Rother CCG
NHS High Weald Lewes Havens CCG
NHS South Eastern Hampshire CCG
NHS Fareham And Gosport CCG
NHS West Hampshire CCG
NHS Portsmouth CCG
NHS Gloucestershire CCG

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13 comments

  1. Lucy Smith says:

    I would be interested to know why CCGs across South of London have not shown an expression of interest

    • NHS England says:

      Dear Lucy

      Thank you for your message. This news item publicised the first CCGs to take on full delegated commissioning responsibility for GP services. Some CCGs, including CCGs across south London, opted at this stage for another co-commissioning model – to jointly commission these services with NHS England. The current list of all CCGs taking on greater responsibility for commissioning GP services in 2015/16 (broken down by delegated and joint commissioning) is available on the primary care co-commissioning section of the NHS England website. There will be other opportunities for CCGs to assume greater commissioning responsibilities for GP services in the future and we will continue to support CCGs in this.

      Kind Regards
      NHS England

  2. jackie fleeman says:

    Hi,
    Will this include the Learning Disability Annual Health Check Enhanced Service?regards
    Jackie

    • NHS England says:

      Hi Jackie,

      Yes. Under current arrangements, CCGs that take on delegated responsibility for commissioning GP services will need to offer this Enhanced Service as part of their responsibilities.

      Kind Regards
      NHS England

  3. Carol says:

    Oh dear – just another process moving money around. CCGs will be no better at spending the money than the existing organisation. Does Mr James think that giving CCGs the money to spend will give him a better chance of seeing a GP.

    And on a separate matter – can NHS England tell me how Healthwatch is funded?

    • NHS England says:

      Hi Carol,

      Co-commissioning is about giving greater commissioning powers to local areas, to improve integration between the range of services that patients need, both in and out of hospital. Local commissioners, working with local patients and stakeholders are in the best position to determine this, so that patients receive the services they need, when they need them.

      Each local Healthwatch is funded by its local authority.

      Kind Regards
      NHS England

  4. Peter Marks says:

    Are you able to provide details of how conflicts of interest will be managed? This is surely a major concern if GP-led CCGs are commissioning GP services.

    • NHS England says:

      Hi Peter,

      The offer to CCGs to take on delegated responsibility for commissioning GP services provides a real opportunity to develop more joined up health services for local people. It is vital that any risks are managed effectively and that health commissioning decisions are fair, transparent and provide value for money. That is why we have worked with stakeholders to provide strengthened guidance on Managing Conflicts of Interest guidance, published on this web page.

      The role of the lay members on the primary care commissioning committee is also critically important. If CCGs take on greater ‘delegated’ responsibility for commissioning primary medical care services, a committee needs to be set up for this specific purpose, which should be chaired by a lay member.

      Kind Regards
      NHS England

  5. Raj Matharu says:

    GP led CCGs commissioning services from GP providers, surely a conflict of interest?
    Any guidance from NHS England will be as helpful as a chocolate teapot, perhaps the asylum has been taken over by……

  6. Jen says:

    What’s the point?
    Will it remove a layer of management or add more?
    Will it lead to more privatisation?

    • NHS England says:

      Hi Jen,

      Local GP-led Clinical Commissioning Groups (CCGs) currently commission the majority of local health services such as hospital care and ambulance services. These new arrangements offer CCGs the opportunity to take on further delegated responsibility for GP services, which are currently commissioned by NHS England. It therefore gives greater commissioning power to local areas and will help drive improved integration of services both in and out of hospital.

      Kind Regards
      NHS England

  7. Cllr. Richard James says:

    Why is Bedfordshire CCGS not included??
    We patients are having continuing problems seeing GPs!

    • NHS England says:

      Dear Mr James

      Thank you for your comment.

      NHS England invited all CCGs across the country to apply to take on greater responsibility for the commissioning of GP services. Three models were offered – full ‘delegated responsibility’ for commissioning primary medical services, joint responsibility with NHS England (which currently commissions GP services) and greater involvement. For further information please refer to the Next Steps guidance.

      This announcement relates to CCGs that applied for full delegated responsibility, setting out those that have been approved to take forward the new arrangements from 1 April 2015.

      Some CCGs have applied for joint commissioning responsibility with NHS England, and the approved CCGs will be announced in the coming weeks. Other CCGs may have not applied at this time but there will be further opportunities for CCGs to assume greater general practice commissioning responsibilities in the future.

      It is the choice of the CCG whether to apply so it may be worth speaking to your local CCGs to understand more about the position in Bedfordshire.

      Kind Regards
      NHS England