By Susan McNulty
NHS chief executive, Sir David Nicholson has said the ambition must remain for the whole country to be covered by clinical commissioning groups.
Speaking at today's Commissioning 2011 event in London, Sir David, said: ‘If you genuinely believe that at the heart of clinical commissioning groups is general practice and if you believe that general practice has the potential to make the changes and shift the services then our ambition has be to cover the whole of the country with clinical commissioning groups that can do that.'
He added: ‘The most important thing for the NHS Commissioning Board (NHSCB)will be its relationship with those clinical commissioning groups (CCGs).'
He warned the NHSCB could turn into the ‘greatest quango in the sky ever seen' and that it must therefore use CCGs as its ‘main engine of change. They are the powerhouse in the system to make it happen.'
The NHSCB would be the only body able to authorise CCGs wanting take on clinical commissioning responsibility he said and their process would involve a ‘360 degree process' with both community members and other clinicians.
Sir David stressed however that the NHSCB would have a ‘helping and supporting role'.
He added: ‘They will also be holding you to account and providing you with incentives and part of that will be the commissioning outcome framework.'
Questioned about areas where GPs were not ready to take on commissioning responsibility, he said support based on PCT cluster geographical areas would exist to help create CCGs ready to take on responsibility.
‘We need to think about the incentives we put in place to make that happen.
‘On one hand, you have clusters themselves that have responsibility of supporting them [shadow groups] to become commissioning groups but on the other hand, when they do that, they lose their responsibility. So how do we put that in the system to make that a reality?'
While the NHSCB does not get its full powers until 2013, he said it would take on powers around authorisation and development of commissioning groups before then.
Sir David Nicholson