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Independents' Day

What will co-commissioning mean for GPs?

NHS England is planning to let CCGs ‘co-commission’ general practice with its local area teams. Read our Q&A to understand what this could mean.

What is co-commissioning?

Co-commissioning is the term chosen by NHS England to describe CCGs taking joint responsibility for commissioning general practice services alongside area teams.

What can CCGs do?

NHS England invited CCGs to express interest by 20 June. They could choose from three levels of co-commissioning: advising area teams on commissioning GP services; holding joint pooled budgets with area teams; or holding some parts of the general practice budget.

What could it include?

Core payments (such as QOF, DESs), discretionary payments (such as premises reimbursement), monitoring contractual performance and deciding on new practices and/or mergers.

Will this see CCGs performance-managing other GPs?

Perhaps, but managing the performers list, revalidation and appraisal would ‘fall outside co-commissioning arrangements’.

What about conflicts of interest?

NHS England argues that CCGs already commission enhanced services from GP practices and therefore have systems in place to manage this, but CCGs have been asked to consider additional safeguards when co-commissioning.

When will it start?

NHS England is hoping for co-commissioning to begin this year, although actually devolving budgets to CCGs would not begin until 2015/16. CCGs have been asked to submit expressions of interest, including what level of involvement they wish to take, by 20 June.

Will this not add extra workload for CCGs, will they get more funding as a result?

CCGs are being asked by NHS England to do this within their existing budgets as far as possible but in some cases area team staff could ‘work under the supervision of’ CCGs.

Will co-commissioning not see CCGs performance managing GPs?

NHS England says not. According to its letter to CCGs, ‘arrangements for managing the Performers List, revalidation and appraisal would fall outside the scope of any co-commissioning arrangements’.

What do GP leaders have to say about this?

The annual LMCs Conference last month voted for policy to be to oppose co-commissioning on the basis that this may undermine CCGs. By contrast the NHS Alliance has been campaigning for CCGs to take on this greater role for some time.

Readers' comments (10)

  • When did the NHS Alliance become 'GP leaders"?

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  • By the time CCGs have taken on the lions share of the work associated with commissioining, you have to wonder how long Area Teams will survive in their current number and size. They seem like an unecessary and rather expensive ? Increasingly redundant layer of beaurocracy now. Surely we could soon manage with far less of them? Some of the grades of area teams posts seem eye-wateringling high - not sure that this is sustainable. Given that CCGs will be doing the work - why let them have the funding?

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  • CCG's are already setting up their own business's and buying their own services!

    Although there is a serious shortage of GP's, many CCG's are made up of GP's clamouring to make a quick buck!

    No doubt everyone is out to line their own pockets!

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  • And before we know it the lines of staff employment in these organisations will be completely blurred and PCTs will be re-born! That's after all the millions of ponds invested in staff consultations and redundancies! Only in the NHS!

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  • The previous comment should have read pounds and not ponds!!

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  • Conflicts of interest a major concern here!

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  • THIS IS DANGEROUS-it means the end of GP freedom and increased bureaucracy-

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  • This is all about devolved responsibility to the ccgs but I doubt the power will follow. Nhs England will still hold the cards. Ccgs currently can't even commission without directives from above. They can even oppose insane ideas like the better care fund and blurring of boundaries between medical and social care which to be honest is a disaster on thr pretence of integrated care. This is a path towards blurring the primary care and the general commissioning budget. Currently the primary care budget is ring fenced. If this comes to pass, it will no longer be. Look forward to working for free once you are over budget as your primary care budget is swallowed up by secondary care!

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  • Vinci Ho

    Simple question:
    What happen if CCG says YES but NHSE says No and vice versa? Anything else is just rhetorical bul***it.

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  • You lot can't spell.

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