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CCGs told to hone their business skills for managing support services contracts

Enter the world of customer/supplier transactions and rigorous evaluation of value for money

Caroline White

Thursday, 09 August 2012

Clinical Commissioning Groups will need to skill up for a quasi commercial market if they are going to effectively manage commissioning support services contracts, when primary care trusts bite the dust next year, says an NHS Clinical Commissioners (NHSCC) report.

The report, which is based on a workshop held earlier this year at the University of Birmingham Health Services Management Centre, aims to help CCGs develop effective relationships with Commissioning Support Services (CSS), which will be providing the non-clinical back-up, traditionally offered by PCTs.

In May a survey of 141 CCGs commissioned on behalf of the NHS Commissioning Board by NHSCC revealed that over half wanted more information on the choice and types of commissioning support available.

And one in four (27%) said they expected to source up to half of commissioning support from NHS Commissioning Support Services, which will become standalone organisations by 2016 at the latest.

The NHSCB has outlined several competencies that CCGs will need, including a clear understanding of what type of commissioning  support they want and whether to build, buy, or share those services.

CCGs will also need the skills to negotiate the CCS contract/agreement and be able to rigorously assess whether it is delivering on effectiveness and value for money, as well as making sure the appropriate governance is in place, says the NHSCB.

The report says that CCG constitutions and governance arrangements will need to be clearly defined and include a process for delegation with clear lines of accountability, and that existing arrangements for working together would benefit from being formalised, reviewed and monitored in the future.

Operating in a market place demands a different set of skills which include a plan for failing CSS organisations, and CCGs could learn from commercial organisations who operate clearer customer/supplier transactions, it says.

CCGs will have to understand contractual, procurement and EU law to enable them to confidently work with CSSs in an effective customer/supplier relationship, says the report.

As CSSs become independent, the wider implications for the system will need to be considered, including whether to support them if they fail or let them go out of business, it says. Contracts will need to reflect fast-changing needs, and provide a quick exit if the service fails.

The Clinical leader’s role needs to be well supported by other commissioning team members and their expertise recognised and used effectively, says the report, while the vital role of the wider multidisciplinary team in offering expert advice and support to the commissioning process needs to be considered in practice by CCGs

Everyone will be operating in a localised, flexible system without a designated system manager, so new leaders and new organisations may benefit from leadership development to adapt their styles and hone their skills, the report suggests.

Organisations within the system will need to learn when and how to take up authority, and when to allow others to lead, says the report. Collaboration is key, but cannot dilute accountability, which remains a constant for every CCG. Processes will need to be fluid to accommodate these tensions, it says.

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