The Department of Health has launched a new tool to ‘flush out' unviable clinical commissioning groups, amid reports from GPs that commissioning groups have already been ‘forced into mergers'.
The ‘ready reckoner' tool has been designed to allow emerging groups to undertake financial modelling and to assess their corporate structure, clinical leadership and staffing, to decide whether they will be fit to function as statutory bodies from 2013.
The tool was unveiled at a joint NHS Alliance and National Association for Primary Care event for CCG leaders in London yesterday by health secretary Andrew Lansley, who said the tool would help commissioners achieve ‘better value' on commissioning support.
Senior DH commissioning leads said the tool was not a budget-setting mechanism but would help identify unaffordable CCGs which were too small to be able to survive.
In an update to CCG leaders this week, Dr Paul Zollinger-Read, the Government's pathfinder learning network lead, said: ‘It will allow CCGs to undertake a range of scenario modelling and most are running a scenario of £25 per head of population or £20 per head. The tool will flush out CCGs that do look unaffordable and these debates need to start now, not in DH but out in your locality.'
Dame Barbara Hakin, managing director of commissioning development at the Department of Health, told delegates at yesterday's conference it would be very difficult for very small CCGs to survive as standalone organisations: ‘Unfortunately, there is a point where the fixed costs leave nothing left to do what you want to do. If you are entirely unable to meet fixed costs, that's not going to work.'
‘We have to flush that out early. There is a way to work together without being a statutory organization. It could be about risk-pooling for services or unforeseen management costs.'
But some CCG leaders told the conference they were concerned they were being forced into a centralised model by PCT clusters and budgetary constraints.
Dr Stewart Findlay, chair at Durham Dales CCG, and a GP in Bishop Auckland, told Mr Lansley: ‘We've always had six very small locality PBC groups in County Durham and we were quite keen to go ahead as six standalone organisations. We're now being forced because of the running costs, which we're being told will be around £20 per head, to merge.'
‘I have a fear that will destroy a lot of the enthusiasm that's been built up.'