Government outlines new commissioning landscape
pharmafile | May 29, 2012 | News story | | CCG, NHS, PCTs, commissioning, health reforms
The government has outlined the new commissioning landscape in England as GPs look to take over commissioning responsibility.
The NHS Commissioning Board Authority, which oversees clinical commissioning groups (CCGs), has published its proposed configuration and member practices for the groups for the first time.
The scheme has been set out in the government’s flagship Health and Social Care Act, but the details of exactly how many groups – and where they will be operating on the ground has now been unveiled.
The Board said that this was a ‘major step forward’ in the work to establish the new clinical commissioning landscape by April 2013, and will enable proposed CCGs to further develop their organisation ready for authorisation and establishment.
The new structure will see primary care trust clusters abolished and replaced with 212 CCGs from April next year.
The figure was expected to be closer to 270 CCGs, but many smaller groups have merged under the direction of the government.
They will replace the 152 primary care trusts that were established under the previous Labour government, and be run by GPs and other healthcare professionals.
NHS North, East and West Devon CCG covers the largest population of just over 900,000 people, and has been given a budget of £21.7 million.
By far the smallest will be the NHS Corby CCG, which covers just 67,800 people, with a budget of £1.6 million.
All 212 CCGs will be responsible for commissioning around £60 billion of the NHS’ budget, with the remaining £45 billion being the responsibility of the Board.
These CCGs are now in the year-long process to be authorised by the Board, and the government says that the majority of CCGs are now undertaking this.
This means that CCGs will have to show that they can be financially responsible, and have the resources to commission services in their regions.
This will all be overseen by the NHS Commissioning Board, which is currently operating as a ‘shadow’ authority.
When it is established as a statutory body later this year, it will check that legal requirements have been met and approve the final details of geography and names of CCGs through the authorisation process.
Dame Barbara Hakin, national director of commissioning development at the NHS Commissioning Board Authority, said: “This is a real landmark moment and is a credit to everyone involved in developing CCGs and the new clinically-led commissioning system.
“We should not underestimate the hard work that has taken place to get us where we are and the huge progress that has been made across the country.
“We have proposed CCGs covering the whole of England. We have 212 groups of practices who have chosen to come together to shape and commission services to deliver better care, better experience, better outcomes and improved safety for their local populations.
“There is still a great deal of work to do as the proposed CCGs move closer to authorisation, but we should take a moment to celebrate this fantastic achievement.”
A ‘drill down’ map of all the 212 CCGs in England is available on the Commissioning Board’s website.
Confusion for pharma
But there is still confusion over how other elements of the NHS reforms will work within this new landscape.
This includes the use of clinical networks and senates, which were added to the government’s plans last year during its ‘listening exercise’.
Their role is to help CCGs with some aspects of commissioning and to hold them to account, but no further details of who will be running then or how they will work have been released.
This has caused considerable confusion for pharma, that has been proactively seeking a new working relationship with these groups.
Speaking to Pharmafocus recently David Thorne, head of the Newcastle Gateshead Alliance and a former industry executive for Sanofi, said pharma had been perplexed by these new additions.
He advised ignoring them completely and focus only on CCGs leaders, but even this will be difficult given their number (which is higher than the previous PCTs) and the variation in their management structure.
Ben Adams
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