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NHS Commissioning Board 'to impose individuals on CCGs'

Exclusive: Some CCGs currently undergoing authorisation are likely to have conditions imposed which could see them forced to take on troubleshooters appointed by the NHS Commissioning Board or even lose certain functions, the Commissioning Board’s commissioning lead has told Pulse.

Dame Barbara Hakin, the Commissioning Board’s managing director of commissioning development, said in an exclusive interview that future waves of CCGs undergoing authorisation were likely to include some given ‘level four conditions and above’.

Wave two CCGs are due to be announced on Wednesday, with waves three and four following in the next two months.

CCGs can be authorised with no conditions, authorised with conditions or not authorised. The 34 CCGs in the first wave announced last month were all authorised, with the most severe condition given at level three, which requires certain decisions to be signed off by the Commissioning Board.

Dame Barbara said: ‘I think it is likely we will see CCGs with conditions of level four and above.’

Under level four conditions, the Commissioning Board places a specific team or individual on to CCGs. Level five would see the CCG’s accountable officer replaced while level six would mean some of the CCG’s specific functions would be removed.

However Dame Barbara rejected claims that level four and above conditions would erode CCGs’ autonomy. She said: ‘The whole of the authorisation process has been designed to be developmental but also designed to make sure that the commissioning of services are safe. The responsibilities of these organisations are massive.’

‘From a patient’s point of view, CCGs are going to be responsible for ensuring the vast majority of health services I need are going to be available and as a taxpayer, they are going to be responsible for a huge amount of money we all pay to make sure we have this NHS which is so precious to us and delivers services free at the point of need.’


Note: this article was updated at 12:08 on 23 January. The original article and headline said individuals or teams were to be imposed on to CCG boards. This was incorrect; the individuals or teams will be imposed by the Board to support the CCGs in this area.

CCG condition levels

1 - No action necessary
2 - NHS board will make advice/expertise available if needed 
3 - NHS board sign-off needed for specific decisions made by the CCG
4 - NHS board will place a specific team or individual on to the CCG
5 - CCG’s accountable officer will not be ratified and an alternative will be appointed          
6 - Specific functions will be removed         
7 - All CCG functions will be removed

Source: NHS Commissioning Board

Readers' comments (5)

  • no decision about me without me...unless its imposed on your contract, CCG's, A+E's .....what is the point?

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  • Has there ever been such a dgree of top-down regulation and micromanagement since 1948?
    So much for the Coalition Agreement (neither party having a mandate from the electorate) that there would be no more top-down reorganisation of the NHS!

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  • Something distinctly Orwellian in this - the pantomime Dame effectively saying: "of course CCG's make decisions independently, we just intend to make sure that they are the right decisions"!

    Give me strength! Do these people have no sense of shame or embarassment at all?

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  • Great news - let's have more of it !
    The # of CCGs is rapidly reducing from well over the 200 mark as :
    * Chief Officers serve as such in a # of CCGs, which are merged in all but name.
    * GPs find that they have the job they spent all those years training to do, to do
    * Partner GPs get fed up with the CCG-GP always being 'At a meeting'
    * Ditto - Patients
    * Level 4 & above CCGs, put the keys thru' NHSCB's letterbox and walk away.
    Who'll give me 20 : 1 that by the end of this year the #s will be < / = to the # of PCTs @ dissolution? ( And outsourced to Management Coys owned by ex PCT high flyers, on n*Original salaries, with benefits.)
    Oh! And PPI might get a look in, please?
    "Nowt abaht uz, wi'at uz," 'appen.
    Josef K

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  • Every one agrees CCG have created a situation where
    there is conflict of interest for all practicing clinicians.
    One can not be a patients advocate at the same time mind the cash box. This affects the decision making in safeguarding the welfare and care of patients.
    We need to make practices accountable for use of resources at the same time patients should take
    responsibility of self care and appreciate what can be delivered and what can not. NHS will be less defensive in practicing medicine. Litigation culture need to be addressed to safeguard the NHS resources.
    Nation has to learn to appreciate what NHS offers and CELEBRATE its success, instead of a constant object of
    Appoint some senior practitioners with street credibility
    and business sense to support the CCG ,implementing CHANGE in a very difficult state of nations financial health.

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