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Commissioning groups overwhelmed by red tape

Raft of decisions needed to set up new system diverting attention from key issues

Caroline White

Thursday, 06 September 2012

The raft of decisions needed to set up the new commissioning infrastructure threatens to overwhelm nascent CCGs and divert their attention from key health and social care issues, NHS Clinical Commissioners (NHSCC) has warned.

And they are in danger of missing out on helping to create the new commissioning arrangements, which could ultimately be to the detriment of their local communities, it suggests.

NHSCC, a joint initiative from the National Asssociation of Primary Care, NHS Alliance, and the NHS Confederation is calling on the government to give CCGs some breathing space and support so that they can focus on how to deliver the best outcomes for their patients.

The NHS Commissioning Board should use the transitional arrangements as an opportunity to strengthen, rather than undermine, the infrastructure needed to deliver day-to-day commissioning responsibilities, it says.

CCGs must be involved in the design of the new system if real and innovative change to the way care is planned and provided is to be achieved, it says, but they are scarcely being given the chance to do so.

Dr Charles Alessi, NHSCC interim chair commented: “These are extremely challenging times for these new organisations, and it is essential they have a say in the way the new system should be structured and delivered.”

He said that just as CCGs were having to deal with authorisation, important commitments were being made that could affect their ability to deliver on local priorities.

"An overwhelming number of rules and regulations are being produced at speed—rules and regulations that will have significant impact on commissioners. So it is essential they have the opportunity to help design and influence them.”

The development of the new system had to be by co-design and not from on high, he warned.

"We are calling on the national bodies to work with us to a proper timetable to get the key rules and commitments produced and to halt the by-passing of CCG views,” said Dr Mike Dixon, interim NHSCC president.

"If we want real and lasting change to the way we commission services then we must give CCGs time to evolve, take stock of the challenges facing their areas, and map out the best path of improving care," he added.

Mike Farrar, NHSCC steering group member, said that CCGs should not be rushed into decisions.

"CCGs should not feel pushed in to making speedy decisions without being given the opportunity to consider the full range of options available to help them transform local services, improve quality and value for money and secure the long-term future of the NHS,” he said.

NHSCC says the proactive involvement of CCGs in policy development over the next few months will be critical. Formal relationships between the government, the NHS Commissioning Board and wider regulatory bodies will filter down into the operational arrangements that CCGs are expected to work within.

NHSCC is currently taking views from its members on the implications of the NHS Commissioning Board's draft mandate, which it will feed back to the Department of Health later in the year.

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