CCGs being planted in ‘hostile soil’, says NHS Alliance chair

The emperor has no clothes most practices are not engaged (despite protestations from the x clinical exec members making up the boards of CCGs) and why should they be - managing disinvestment in hospitals and community services isnt exactly a great selling point.

It is too late for CCGs and their members to walk. GPC has already agreed in principle to align the GP contracts to CCG membership when the bill is finally ratified. It will take another parliamentary process to allow GPs to walk away from being part of CCGs or accept the penalties. NHS Commissioning Board will come with the same old NHS culture which was the core of SHAs and PCTs - the current recruting and grooming ground for the members of shadow NHS Commissioning Board. Even the authorisation process for CCGs is riddled with PCTs' vision and priorities that many CCGs are being forced into unwanted mergers by ensuring very short time for assessments and proper development of local sustainable alliances.

Dr Peter Patel
CEO - South Birmingham Independent Commissioners
Boad Member - Trans Wallsall Independent CCG

Whilst CCGs and their members cannot formally walk away, they can disengage and leave the managers with free rein.

if you look at the history of PCTs, it all started with apparent clinical involvement in a central position i.e the PEC. Over the years, the numbers of GPs willing to be involved declined and PECs filled with non-doctors. Even these became steadily more powerless and, in my area, the PCT abolished the PEC, replacing it with an 'advisory committee' with no powers to truly guide policy or implementation.

The latest guidance "Developing commissioning support: Towards service excellence" means that CCGs will find it very difficult not to devolve large amounts of work, influence and power to commercial companies providing "commissioning support". We are also still to find out how interventionist the nation Commisioning Board will be.

Put all this together and ther is a high risk that practices are disempowered and disengaged but still carry the can for the disinvestment that is going to happen.