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CCGs further widen health inequality, analysis shows

Exclusive: Deprivation is much more polarised across clinical commissioning groups than it has been under PCTs, suggesting the Government’s NHS reforms risk further widening health inequalities.

A Pulse analysis of data from every CCG in England shows that the variability in deprivation across some SHAs is double that between PCTs.

The findings suggest GP practices in more affluent areas have sometimes clumped together in CCGs, leaving practices in more deprived areas to form their own groupings.

A recent study published in the British Journal of General Practice found deprivation had a greater influence on the effectiveness of PCTs than size. Our analysis of National General Practice Profile data – recently published by the public health observatories – suggests such divisions could widen.

The variance in deprivation scores across 272 CCGs in the analysis was 33.76, compared with 25.47 across 132 PCTs. 

There were significant differences across the country, with deprivation far more polarised in some SHAs than in others.

CCGs in the NHS Yorkshire and the Humber region had almost double the variance of deprivation of PCTs in the same SHA, with CCGs having a variance of 30.40 compared with 16.30 for PCTs. There was also a big chasm in the East of England, with CCGs having a variance of 14.00 compared with a score of 7.65 for PCTs.

But in the North East, the gap was much closer, with CCGs having a variance of 29.56, while PCTs have 29.40. In London, where most CCGs are co-terminus with local authorities, their variance was 37.78, compared with 35.63 for PCTs.

Dr Kambiz Boomla, chair of City and East London LMC and a GP in Tower Hamlets, east London, said: ‘This could lead to a fragmentation of the public health responsibilities of CCGs.

‘It will depend on whether geographical areas remain discrete, and whether the funding in the capitation formula for deprived areas adequately deals with that deprivation, or will deprived areas have to make cuts in services?’

Dr Mike Parks, medical secretary of Kent LMC, where CCGs have generally formed smaller groups than PCTs, said there could be an advantage with more deprived practices grouping together.

He said: ‘If they survive, this improves their ability to deal with population needs.’