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NHS England aims for 'as many CCGs as possible' to commission GP services from next April

NHS England wants ‘as many CCGs as possible’ to start commissioning general practice by 1 April 2015, in a radical move to devolve responsibility for managing primary care to CCGs.

In guidance issued today, developed alongside NHS Clinical Commissioners, it has said CCGs must choose how much responsibility they want for primary care by January 2015, including options to have greater involvement in NHS England decisions, to jointly commission services with local area teams, or even take full responsibility for GP services.

NHS England said that CCGs will be supported to move to co-commissioning by April, subject to the CCG not being in ‘special measures’.

Under the new guidelines, any CCGs wishing to take responsibility for commissioning primary care on their own would not be able to cherry pick responsibilities, and would take full control of:

  • GMS, PMS and APMS contracts (including the design of PMS and APMS contracts, monitoring of contracts, taking contractual action such as issuing branch/remedial notices, and removing a contract);
  • Newly designed enhanced services (‘local enhanced services’ and ‘directed enhanced services’);
  • Design of local incentive schemes as an alternative to the QOF;
  • Decision making on whether to establish new GP practices in an area;
  • Approving practice mergers; and
  • Making decisions on ‘discretionary’ payment (e.g., returner/retainer schemes).

The document said: ‘The aim is to support as many CCGs as possible to implement co-commissioning arrangements by 1 April 2015. Unless a CCG has serious governance issues or is in a state akin to “special measures”, NHS England will support CCGs to move towards implementing co-commissioning arrangements.’

It comes after Pulse reported last that two thirds (66%) of CCGs expressed in their initial submission from June this year that they wanted full delegated primary care commissioning.

As previously reported, the new arrangements will allow CCGs to design local incentive schemes as an alternative to QOF and DESs, which will require them to ‘consult’ with LMCs, but would remain voluntary for practices.

NHS England will remain responsible for administration of practice payments and practice list management, as well as individual GP performance management, performers list management and revalidation.

CCGs or joint committees will also be unable to vary any nationally determined elements of GMS, PMS or APMS contracts.

But NHS England warned CCGs: ‘There is no possibility of additional administrative resources being deployed on these services at this time due to running cost constraints.’

The guidance also stated that CCGs will need to change their constitutions in order to take on commissioning of primary care, and they will be able to take on more or less responsibility in the future.

NHS England national director of commissioning strategy Ian Dodge and NHS Clinical Commissioners co-chair Amanda Doyle said in a joint foreword to the document that although they ‘are confident that co-commissioning - or delegation to CCGs - is in the best interest of patients’, it is up to every CCG to decide how to respond to the invitation.

Readers' comments (10)

  • ‘are confident that co-commissioning - or delegation to CCGs - is in the best interest of patients’

    which is so obviously evidence based.

    Is it true that locums can vote for ccg board members within a ccg?

    if so that is dangerous!

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  • Vinci Ho

    The question remains:
    Will CCGs become the subordinates of NHSE to implement political missions? Or do they have any freedom to deliver care that is needed?

    Devolution , why now? NHSE is now labelled opaque and non transparent. It needs to look for more scapegoats to share the blame......

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  • yet another poisoned chalice.CCG's cannot cope with current demands with their stripped down admin staff-remember the best left when PCT's 'transformed' and what of conflict of interest with some of our up high collegues commisioning their own services.

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  • 'Confused and opaque' NHS England insufficiently accountable to the public, says MP report.........

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  • CCGs evolving back into PCTs. So we go through a massive expensive redisorganisation of the NHS to end up back where we started...........

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  • "Niall Bacon | GP Partner | 11 November 2014 9:52am
    CCGs evolving back into PCTs. So we go through a massive expensive redisorganisation of the NHS to end up back where we started..........."

    And the previous Labour Govt morphed HAs into level 1 PCGs then drove them to level 4 then on to PCTs which pretty much resembled the HA (it was the same staff in the same building doing pretty much the same job.....). So we are going to end up back where we were in the 1990s with HAs but having spent eye watering sums of money playing musical chairs and causing loss of productivity along the way. The cost of Lansley's disaster reform would have paid for 5 years of the 1% pay rise for NHS staff that the Govt has refused them on the basis that there is no money. Of course there is no money, they have spent £billions on the "reform" according to the National Audit Office. Funny how the preening narcissitic Secy of State could find those £billions for his vanity project but not find a fraction of it for a sub-inflation pay rise for the staff.

    All the re-disorganisations are not the "necessary reform" that the various Secretary of States claim the NHS needs, but merely egotistical vanity projects. The management of the NHS is continually destroyed at phenomenal cost to the taxpayer simply to feed the strutting ego of one here today gone tomorrow politician. The next Secretary of State who claims their department needs "reform" should be shot.

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  • This is going to be the most monumental clusterf*** yet.

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  • CCG should be able to police GP contracts.
    NHS England following on backing the defunct PCTs have driven the country and its health bankrupt by advocating apparently cheap medicines to GPs to prescribe whose treatment of sideffects in secondary care and costs of health implications to british public is enormous

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  • Back to PCTs again, hey ho!

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  • same old wheel reinvented, just different type of s'''''te to wade through

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