Exclusive: CCGs have announced plans to share consultant and nurse representatives across boards in order to mitigate recruitment difficulties and smooth the passage to authorisation.
The Health and Social Care Act stipulates all CCGs must have at least one secondary care doctor and nurse on their governing body to ensure adequate representation, but stated these must be appointed from outside local areas to avoid conflicts of interest.
But after a Pulse investigation in June found only 7% of CCGs across England had managed to appoint a secondary care doctor to their board, NHS chief executive Sir David Nicholson announced a potential rethink, saying he was ‘very open’ to relaxing the legal stipulation that they must come from outside the area.
As CCGs gear up to undergo site visits from the NHS Commissioning Board as part of their authorisation process, NHS London revealed CCGs in the capital have made slow progress in finalising their boards, with some likely to share consultants to ensure they are authorised.
Leading GP commissioners said recruiting consultants from outside to sit on boards had been challenging, with one leader saying they had appointed a retired local consultant to avoid any conflicts of interest.
Board papers from NHS London said the status of its 32 CCGs, as of last month, was: ‘Six CCGs have appointed secondary care doctors.
‘Some CCGs plan to share secondary care doctors and three out of 26 vacancies across London have been appointed. Eight CCGs have appointed nurse members. Some plan to share nurse members and five out of 26 vacancies across London have been appointed.’
A spokesperson for NHS London added: ‘It is for the CCG to decide how it will discharge its responsibilities within the legislative framework, which will be subject to the NHS Commissioning Board’s CCG authorisation process. ‘
Dr Sam Everington, a GP in Bromley-by-Bow, and chair of Tower Hamlets CCG, said his CCG had recruited a retired consultant to its board to mitigate the difficulties with recruiting one from outside the area.
He said: ‘We’re not planning to share, but I know others have struggled to appoint somebody, and it’s mainly because of the issue around having to find somebody external to your local area.
‘What you really want is a consultant with local expertise and knowledge, and that makes it very difficult to recruit somebody.
He added: ‘What we’ve gone out to do is look at people who have recently retired from the local trust, and a number of other CCGs have done that too, to get the best of both worlds. You’ve dealt with the conflict of interest but you’ve got somebody who absolutely understands the people you have got local contracts with.’
Dr Johnny Marshall, a GP in Wendover, Bucks, interim partnership development director of NHS Clinical Commissioners, and an adviser to the NHS Commissioning Board, said many CCGs had struggled to recruit consultants with the ‘right skills and perspective’.
He said: ‘There has definitely been a difficulty in identifying and recruiting secondary care consultants and nurses with the right skills and perspective who are not local.
‘I know that some CCGs even outside London have been inviting the same nurses to sit on more than one governing body. It is not just in London that people have been looking at that.’
Who should be on CCG boards?
1. Someone with a professional qualification or expertise in accountancy
2. A registered nurse (but not an employee of any service contracted by the CCG)
3. A secondary care specialist (but not an employee of any service contracted by the CCG)
4. Two lay people
Source: NHS (CCG) Regulations 2012