The Department of Health is working on a series of recommendations on the size of clinical commissioning groups (CCGs) with GP leaders that will be published in the next few weeks.
The document – being drawn up with the help of the NHS Alliance and the NAPC – will provide guidance on what size is ‘reasonable' for a CCG, although it is being hampered by not knowing the management allowance commissioners will be allocated for running costs.
NHS Alliance chair Dr Michael Dixon, a GP in Devon, said the forthcoming advice wouldn't provide an ‘absolutely black and white steer' on commissioning group size, but would give CCGs an idea of what is practical.
He said: ‘I suspect the more likely outcome of the work will be to establish what size is reasonable from the point of view of likely management fee/corporate and financial governance, but appended to an answer to the question of how we keep "small is beautiful" in terms of frontline involvement and power.'
Leading the work is the NHS Alliance national director for clinical commissioning Julie Wood. She told Pulse: ‘It is difficult because we don't have the running and management costs and it would be good to get clarity sooner rather than later over those costs to help CCGs work out what resources they will get .'
She added: ‘There are some unavoidable costs irrespective of size which you have to be able to cope with and you have think about what that potentially leaves in terms of running cost allowance and we don't know what the running cost allowance will be at the moment.'
‘The smaller a CCG is the more you need to think how you share with others, but we will not be recommending absolute sizes because there is no right size it is more subtle than that.'
‘In contrast large CCGs will have to decide how they deal effectively with local sensitivities.'
