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GPs must maintain commissioning role as CCGs merge

Report stresses clinical role in commissioning changes

Adrian O'Dowd

Friday, 24 May 2019

The role of GPs in organising care must be maintained as part of significant changes to commissioning arrangements in the NHS in England, according to a report published yesterday.

The report by NHS Clinical Commissioners, the representative body of clinical commissioning groups (CCGs), warns that planned changes to commissioning as part of the NHS Long Term Plan must not result in any less of a role for GPs and clinicians in this area. 


The report The changing face of clinical commissioning highlights the strengths and successes of nine CCGs across England while stressing that clinical leadership must not be lost as the NHS works towards the ambitions of the NHS Long Term Plan.

There are currently 191 CCGs across England (although this number is likely to change in the future), responsible for approximately two-thirds of the NHS England budget.

Under the Long Term Plan, CCGs will merge with the formation of integrated care systems (ICS).

The report authors said it was crucial to retain tangible “place” level links and responsibilities.

“CCGs have formed working relationships with others in their ‘place’, especially local government. As they increasingly work at larger ‘system’ footprints, the important work at place level should not be lost,” says the report.

In addition, it was important to keep “stewards” and the system perspective, they argued. CCGs could make sure providers were doing the right thing for their population as they were the only ones without vested interest so their voices within systems had to be heard.

Keeping clinical engagement at the core of commissioning was another essential element, said the authors.

“CCGs have been successful in embedding clinical leaders and the expertise, credibility, and better health outcomes this brings. This must be maintained as we move to more system working,” they said.

The report was intended to showcase the unique perspective brought by clinical commissioners, specifically, the clinical expertise, collaborative working with provider and local government colleagues, and an understanding of the population’s needs in the system in which they operate, said the authors.

In the report’s introduction, Julie Wood, chief executive of NHS Clinical Commissioners, said: “CCGs will increasingly work across larger populations and more closely with provider and local authority colleagues but the decisions they make should be at the level that is most appropriate, at neighbourhood, place or system level.

“This principle of subsidiarity means that even as the new NHS landscape emerges, there will be a role for clinical commissioners.”

NHS Providers, the body that represents NHS hospital, mental health, community and ambulance services, welcomed the report, saying there would be more opportunities for strategic commissioning.

Its director of policy and strategy Miriam Deakin said: “This report provides an interesting and forward-looking exploration of the role of commissioning within the context of system working.

“Delivering the NHS Long Term Plan will mean that commissioners and providers will need to work differently and most importantly in partnership with one another and other local health and care organisations.

“It is clear that there are opportunities for more strategic commissioning across a larger population base, providing better value and becoming more outcomes driven.

“This in turn creates opportunities for the role providers could play within their local health and care system with scope for NHS providers to take on some of the activities that commissioners currently deliver, and to develop more collaborative approaches with their colleagues in commissioning.”

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