WA recently held a breakfast briefing on the changes in the health commissioning landscape, focusing particularly on clinical commissioning groups (CCGs). The area continues to evolve with a new government and the NHS efficiency agenda. We were delighted to hear from Julie Wood, Chief Executive of NHS Clinical Commissioners, on the challenges from a CCG perspective and the implications for providers. We thought we would post a blog with our further thoughts on the subject.
The new Conservative government signalled a clear endorsement for local clinically-led commissioning. CCGs are now firmly at the forefront of the new local healthcare system in England. However, beyond the challenges of equipping clinical leaders with the skills to oversee market development and commissioning for good patient outcomes, CCGs are also fundamental to the success of the transformation programme set out in the Five Year Forward View.
For providers, demonstrating an understanding of this complex environment is crucial to working effectively with CCGs. Across 200 CCGs the pace and scale with which they have absorbed commissioning responsibilities from NHS England varies. This ranges from a delegated arrangement to jointly commissioning services. Numerous CCGs are involved with vanguard sites, piloting NHS England’s new models of care.
Despite this variation, CCGs share several common challenges. CCGs are seeking to strengthen ties with local authorities, health and wellbeing boards and indeed other CCGs. This aims to facilitate integration across local care provision and provide better care pathways for patients. The needs of a local area will increasingly be reflected in joint strategic needs assessments (JSNAs) offering a clearer indication of priorities to providers.
As areas build on their clinical and local knowledge of the patient populations, we may also expect more CCGs to consider how, and with whom, services could be reconfigured more innovatively. This could mean the lines between commissioner and the provider are blurred as collaborative, outcomes-focused arrangements emerge. These might also involve innovations such as risk-sharing, accountable care systems and capitated budgets.
While CCGs look set to remain a significant player in shaping local health systems they will continue to evolve. For example, in accommodating regional initiatives to coordinate health economies and systems within England or in taking greater responsibility from NHS England on specialised commissioning. There is also speculation the Spending Review 2015 may offer a longer-term funding settlement for CCGs to support improvements in how care is delivered and organised. Providers will need to monitor and adapt to CCGs evolution.