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DH reveals authorisation criteria for GPs to take on commissioning

GPs will be judged on their ‘track record to date' in delivering NHS efficiency savings before they are handed full commissioning responsibility by the NHS Commissioning Board, the Government has revealed.

Emerging clinical commissioning groups (CCGs) will also have their size and shape assessed to judge whether they are fit to take on PCT functions, and will begin the application process as early as this October.

A draft Government document, Developing clinical commissioning groups: Towards Authorisation (download the full document here) lays out six key competency domains that CCGs will have to meet in order to be handed full control of NHS commissioning budgets.

It discloses that CCGs will need to undergo initial risk assessment of their configuration from October 2011 - and ideally no later than December 2011 - and said the NHS Commissioning Board could begin to receive applications for authorisation from summer 2012.

No CCG will take on full commissioning responsibility until April 2013 at the earliest, but the document reveals GPs will be authorised based on their proven ability to deliver as commissioners in shadow form.

It says: ‘As ‘start-up' bodies, CCGs will be building a track record of performance - therefore authorisation will focus on confidence in their potential to deliver, drawing on their participation in, for example, improving care of long-term conditions, clinical care in general and other aspects of QIPP, but will also draw on their track record to date as sub-committees of PCTs to whom certain commissioning responsibilities have been delegated.'

CCGs will be asked to undertake a final risk assessment of how their proposed structure will impact upon their ‘organisational viability' and the extent to which they will need to consider sharing roles, functions or use of commissioning support.

‘This will need to consider the risks of both very small and very large CCGs,' the document says. ‘From our understanding, many emerging CCGs are already likely to score green against most aspects of such an assessment.'

Once authorised,each CCG will face an annual assessment to determine whether it requires ongoing support or conditions attached to its status, based on ‘performance and other aspects of its organisational capabilities and relationships'.

A Department of Health spokesperson said: ‘This initial thinking, which has been developed by a range of stakeholders, represents our preliminary proposals for authorising clinical commissioning groups.'

‘This will support emerging clinical commissioning groups in their development and enable them to be as prepared as possible for authorisation as well as taking on responsibility for healthcare budgets and improving services for their local communities.'


The six key domains against which CCGs will be assessed prior to authorisation

1. A strong clinical and professional focus which brings real added value;

2. Meaningful engagement with patients, carers and their communities;

3. Clear and credible plans which continue to deliver the QIPP (quality, innovation, productivity and prevention) challenge within financial resources, in line with national outcome standards and local joint health and wellbeing strategies;

4. Proper constitutional and governance arrangements, with the capacity and capability to deliver all their duties and responsibilities including financial control as well as effectively commission all the services for which they are responsible;

5. Collaborative arrangements for commissioning with other CCGs, local authorities and the NHS Commissioning Board as well as the appropriate external commissioning support;

6. Great leaders who individually and collectively can make a real difference.