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CCGs are embracing change and are key to shaping health landscape

Commissioning must be clinically led, at larger scale than CCGs, accountable and retain purchasing

Louise Prime

Wednesday, 27 September 2017

Clinical commissioning groups (CCGs) are embracing change and clinical commissioners have a “key role as architects of the changing health and care landscape”, according to the latest analysis by NHS Clinical Commissioners (NHSCC), published this morning. In Steering towards strategic commissioning, NHSCC reported a strong belief among clinical commissioners that healthcare commissioning must continue to be clinically led, operate at a scale larger than a CCG footprint, retain its purchasing function and remain accountable to the local population.

The new analysis comes from a research project undertaken on behalf of NHSCC, which was informed by survey results from 34 CCG leaders (who between them cover 43 CCGs) and by 14 in-depth interviews with CCG leaders. The results of the survey and interviews showed that CCGs are evolving at pace, positively embracing the evolution of commissioning and provision to facilitate new models of care – they see it as providing opportunities for improved long-term health and social care outcomes. Many said they are actively engaged in developing new models of care on the ground, as well as working at scale through collaborative commissioning.

Most (93%) CCG leaders said they are “actively seeking” early lessons on the new care models; 77% are planning to contract for a new care model in 2017/18; 74% felt their CCG fully understood the opportunities presented by new care models; and 72% plan to increase their collaborative commissioning.

The CCG leaders surveyed tended to see “strategic commissioning as the future destination”, and said they believed it must be clinically led, operate at a scale larger than a CCG footprint and be recognisably accountable to the local population in order to hold providers to account.

NHSCC co-chair Dr Amanda Doyle commented: “CCGs are leading transformation in their local area and are absolutely seeing strategic commissioning as the future destination which will bring about better care for patients. Our analysis today reinforces the message that through these changes strong clinical leadership in commissioning must be preserved to ensure its credibility.”

But the analysis also revealed that CCG leaders are facing several challenges as the system evolves – among other things, regarding current capacity and capability to undertake strategic planning for population level; and the need for speedy sharing of best practice from accountable care organisations (ACO) and accountable care systems (ACS) areas. NHSCC said that to tackle these challenges and support CCGs in the future commissioning landscape, it has identified six ‘asks’ for national stakeholders:

  • increased sharing of best practice
  • national clarity on the direction of travel
  • support for clinical commissioning leaders to manage change
  • time, resource and space to transform
  • support with capabilities to support strategic commissioning – key skills and tools needed are data gathering and analysis, predictive modelling, succession planning and organisational development
  • an improved regulatory framework, that is one system, mirroring the situation on the ground with the development of ACOs and ACSs.

NHSCC co-chair Dr Graham Jackson said: “CCG leaders are agreed that moving towards a more strategic integrated commissioning function is the right way forward to ensure that the populations we serve are provided with the best possible services within the resources allocated.

“However, we are seeing some potentially significant risks that could slow this down. Among these are a lack of clarity in the national direction and low confidence in regulators being able to match the pace of transformation.”

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