Health secretary Andrew Lansley and the NHS Alliance have both emphasised the importance of localism in commissioning.
In his letter to chair of the NHS Commissioning Board Authority Professor Malcolm Grant, the health secretary set out the four strategic objectives against which his department will hold the Authority to account. He told him: “The principle of decentralisation of decision-making and promoting the autonomy of CCGs must be embedded within the culture of the Board,” and stressed: “The first – and overarching – objective is to design the Board so that it transfers power to local organisations.”
The other three objectives against which the authority’s performance will be measured are:
- establishing the commissioning landscape
- developing specific commissioning and financial management capabilities
- developing excellent relationships.
Localism was also a key theme for the NHS Alliance at the Westminster Health Forum. Co-vice-chair Dr Donal Hynes insisted that clinical senates and networks must act as a support mechanism for clinical commissioning groups’ localism and not be allowed to undermine their autonomy.
He told delegates: “If clinical senates and networks feel that they need to ‘control’ CCGs, we will be then recreating a top-down bureaucratic structure that will undermine CCGs’ localism.
“Local decision-making should remain strongly in the hands of clinical commissioners and their population. Clinical senates and networks should be able to respond to and work with CCGs, without imposing their views on the localities … we need clinical senates and networks that are led to support CCGs and meet the local agenda.”
He warned: “The NHS cannot afford to fail, so we simply cannot accept the old clinical tribalism and clinicians or specialists working in silos to undermine the work that CCGs need to do in their communities.”