It is becoming clear that local area teams are actually quite small and not only will they need the expertise of the CCG, they will also need the granuality they can lend in terms of primary care in different areas.
I would like to see the CCG able to look at care in the locality - not only looking at hospitals and community services, but also looking at primary care and having flexibility in redistributing resources in the different areas.
We have to put resources into primary care to reduce the number of people going into casualty in the first place. Therefore we need CCGs to have a greater role in not only improving primary care through peer pressure but getting resources in the right place.
[With regards to conflicts of interest], there are a lot of issues about better resourcing in primary care and general practice that don’t have to do with personal income and where they don’t, I think these CCGs can make the decisions. Where they do, there will need to be signed off from NHS England, either centrally or through the local area team.
It is inevitable that CCGs will have more say in primary care commissioning. It will vary from CCG to CCG depending on the willingness and ability of that CCG to become involved in improving primary care and the willingness of the local office to devolve that responsibility.
There does not need to be any formal changes at the moment as we are in a fluid system. Much better to let things bed down and see what works than to have things formalised that doesn’t allow that fluidity.
Dr Michael Dixon is the chair of the NHS Alliance and interim president of NHS Clinical Commissioners