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NHS England chief to draw up CCG co-commissioning plans this week

The new chief executive of NHS England has said that handing CCGs part of the primary care commissioning role is one of his first priorities in his new post..

Simon Stevens, who replaced Sir David Nicholson at the helm of NHS England earlier this month, was facing the House of Commons Health Comittee for the first time when he said that the opportunities for CCGs to ‘drive change’ in the NHS have been partly unrealised because they don’t commission primary care.

He said: ‘I think there is potentially an opportunity for CCGs to drive change. I don’t think frankly we have got that completely right just yet… I think CCGs probably will do well when they can have more responsibility for some of the primary care services in their area.’

‘And I think that we will have to make some changes around how commmissioning for specialist services are done as well so that we have got that population focus rather than a three way split in the local resourcing between the primary care services, the local hospital services and the specialist hospital services.’

‘So part of what I am doing now, in my first few weeks, is just working out how we can evolve the system a bit to get some of that in place.’

He also went further to say that handing CCGs this greater input in how primary care services are run may even help to solve the general practice workforce crisis – although he did not explain how this would work.

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Asked by Dr Sarah Wollaston, the former GP and Conservative MP for Totnes in Devon, how he would make ‘a real national drive’ to grow the general practice workforce, Mr Stevens said that while the general practice workforce has been rising, it has been ‘out of kilter’ with the corresponding growth in the number of secondary care consultants.

He said: ‘Fundamentally, what you were saying about general practice workload, my view is that GPs are working incredibly hard and are under pressure as a consequence. There has been a 21% increase in the number of GPs since 2000 but that is a by far smaller proportional increase than the increase in the number of consultants in hospitals which I think has been more like 76%.’

‘So I think it is an interesting question as to whether we have got the balance out of kilter there, and if we have, what are we going to do about it going forward. And one of the answers I think is to enable CCGs to have more impact over the decisions that are made about spending in primary care services, not just GP services, but primary care services.

‘And so… I think I will indeed be setting out an answer to that at least in outline terms on Thursday of this week.’

NHS England’s plans for CCGs to jointly commisison primary care with its local area teams were first revealed by Pulse last year.