The chair of the NHS Alliance has appealed for the right balance between the centre and CCGs or risk the latter walking away from the reforms.
Speaking at a London conference earlier this week, Dr Mike Dixon, said: ‘Clinical commissioning is a really good seed but it's being planted in fairly hostile soil. Only have to look at the Department of Health today and see there are hardly any clinicians. Those that are there are all secondary care clinicians, mainly senior managers and so there is vast vested interests in this (current) system.
‘We're going to have to get this balance between local and centre absolutely right.
‘There are two real dangers. One is that the commissioning board will become like the Department of Health and the CCGs will walk. The other danger is that the CCGs might become the new tyrants and the practices will walk, just like they did with PCTs.'
Speaking at the same Wellards annual conference, Professor Chris Ham of the King's Fund questioned CCGs capability to handle complex commissioning involving hospital care.
‘What we expect CCGs to be really good at is looking at disinvestments around community based services that really make a big difference to how practices work. What they will struggle to do is engage with those more complex disinvestments that we need, especially where that involves hospitals having to merge or to agree on how some specialist services ought to become much more concentrated to deliver the best possible quality of care because there's no evidence that primary care led commissioners in the past have had that capability or indeed any interest in so doing. That's why we feel very strongly that alongside what CCGs can offer, you need to have strategic commissioners somewhere in the system working with CCGs on those very complex disinvestments of care.'
