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Clinical commissioning groups bullied over size

CCGs should be able to decide what size is appropriate for them

Louise Prime

Friday, 14 October 2011

Clinical commissioning groups should be able to make their own decisions on what size is appropriate for them, and not be bullied over the matter, says the NAPC/NHS Alliance Clinical Commissioning Coalition.

The Coalition says that neither primary care trust clusters nor strategic health authorities should be putting pressure on CCGs to conform to a particular size. But, it says, commissioning groups have already experienced harassment.

Dr Charles Alessi, the National Association of Primary Care’s chair elect, said: “Of course there will be issues, ranging from the costs of corporate governance to the management of financial risk.

“But these will need to be balanced with the all-important need to keep engagement and close relationships with local GP practices, clinicians and patients.”

Dr Michael Dixon (pictured), chair of the NHS Alliance, agreed. He added: “Each CCG will need to provide a good case for its composition and size. No-one really knows what the ideal size of a CCG is and we need to remember that this is bound to vary according to circumstances and geography.

“The worst case scenario is that the future size of any CCG depends upon the presumed management allowance and costs of running a statutory organisation, rather than the size that is necessary for them to carry out their functions most effectively.”

The Clinical Commissioning Coalition has found that many CCGs have already, and still are, being bullied on the issue of size – which, it says, is “quite contrary to all the principles of locally-led clinical commissioning”.

Dr Dixon said that the Clinical Commissioning Coalition and Department of Health are conducting a joint analysis into the smallest reasonable size a CCG can be and yet still meet the requirements for future National Commissioning Board authorisation. “Until this work is completed,” he said, “it is entirely inappropriate for either PCT Clusters or Strategic Health Authorities to dictate to their constituent CCGs how large or small they should be.”

The Coalition is encouraging any CCGs under pressure from PCT clusters and SHAs to get in touch with Julie Wood, national director for clinical commissioning at the NHS Alliance, for support.

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