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Are CCGs truly in control of their own destiny?

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The NHS Commissioning Board has trumpeted the fact that every CCG in England has been authorised – firing the starting gun on a new world of a GP-led health service.

Everyone is more or less ready, we are told, but a quick look at the details of the wave four CCGs being authorised suggests that beneath the surface everything is not as it seems.

Some CCGs have been authorised in name only. A total of 15 CCGs will have ‘legal directions’ placed on them, meaning the NHS Commissioning Board will appoint troubleshooters to help them with certain functions.

Of these 15, three – NHS Basildon and Brentwood CCG, NHS Thurrock CCG and NHS Waltham Forest CCG  – will be unable to choose their accountable officers themselves and will even have specific functions removed.

The CCGs themselves are not necessarily to blame for needing this level of support. In the NHS Vale of York CCG, for example, the legal directions relate to the historic debt that it is inheriting from NHS North Yorkshire and York PCT.

Even in NHS Basildon and Brentwood CCG and NHS Thurrock CCG, there are historical reasons for the lack of engagement from practices and the huge number of conditions they are facing.

But the overall impression is that there will be far greater central involvement from the national Commissioning Board than the Department of Health promised, and many GPs would like.

There is no doubt these CCGs do need substantial levels of support – in the case of NHS Basildon & Brentwood CCG and NHS Thurrock CCG, support in every area of its responsibilities.

With just over two weeks until the reforms are implemented, it feels like a political decision to authorise every CCG, even when some do not seem ready.

Jaimie Kaffash is a senior journalist at Pulse

Readers' comments (4)

  • No they arent. Wait until the new year pans out and the dictats start flowing from the NCB just like the DH did to PCT's. Dont forget the names on the doors have changed by the people at the top and the control mechanisms havent.

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  • Hardly surprising there are problems in South Essex (Basildon, Brentwood, Thurrock) given the PCT they have been dealing with

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  • andrew Field

    We can all smell the central interference and imposition of "local" priorities from on high. Member practices will need to be very careful what they agree to and use their LMC wisely.
    For example in Vale of York, mentioned in the article, referral management is on the agenda. It won't be popular.

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  • Entirely in charge of anything left to decide after NHS commissioning board, NHS Property Co, NICE, Care Quality Commision, QOF, Group of Elders, Social Care via the local Council, and undoubtedly several others I have forgotten to mention have had their say.
    In short : not in charge whatsoever, but ideally placed to take the blame for anything that will go wrong with the NHS in the next few years. Unfortunately that is likely to be an awful lot.

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