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Majority of co-commissioning bids ready to go ‘now or soon’

The vast majority of CCGs who have expressed an interest in co-commissioning primary medical care will be ready to start now or in the immediate future, NHS England has said.

Speaking at NHS England’s board meeting last week, Dame Barbara Hakin, NHS England’s chief operating officer, explained that 74 CCGs have requested ‘delegated authority’ – meaning they will design and negotiate PMS contracts and monitor contractual performance among other things – and that 20 of these are ready to begin immediately.

In total, all but 15 of 211 CCGs have declared their interest in co-commissioning, with 110 saying they would like to do ‘joint commissioning’ where they form a joint committee with the local area team, and 19 saying they just wanted more dialogue with their area team.

Dame Barbara explained that NHS England will now ensure CCGs wishing for delegated powers undergo audits of their governance process to ensure that any potential conflicts of interest are declared and that GPs excuse themselves from decisions where conflicts might arise.

She said: ‘110 CCGs want to do joint commissioning – which means they’d have a joint committee with our area team and all work together on the commissioning of primary care.’

‘And 74 want to take delegated authority for some aspects of primary medical care commissioning.’

‘Encouragingly the vast majority [of bids] are ready now or ready soon. And very specifically, out of the delegated authority – where there are 74 if you remember – we think that about 20 will be ready now, and 45 will be ready soon. And only nine will be ready later.’

However, she said NHS England had to be vigilant about conflicts of interest.

Dame Barbara said: ‘We will be looking particularly at those expressions of interest which include delegated authority, because those are the ones… where we have to be very vigilant about conflicts of interest.’

‘We will need to test every single one of those and make sure, that where they are making decisions about GP service, those conflicts of interest are covered.’

‘They should already have in place arrangements whereby GPs who have any interests declare it, as we do here [at NHS England], and stand aside from any decisions or discussions that are to be made.’

One of NHS England’s new chief executive Simon Stevens’ first acts was to offer CCGs the chance to co-commission primary care to support plans to move care from hospitals.

However, the plans were opposed by GP leaders at the annual LMCs Conference in Harrogate, with the plans being described as ‘the ultimate poisoned chalice’.

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