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What will co-commissioning mean for GPs?


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.