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NHS Commissioning Board ‘to impose individuals on CCGs’

Exclusive: Some CCGs currently undergoing authorisation are likely to have conditions imposed which could see them forced to take on troubleshooters appointed by the NHS Commissioning Board or even lose certain functions, the Commissioning Board’s commissioning lead has told Pulse.

Dame Barbara Hakin, the Commissioning Board’s managing director of commissioning development, said in an exclusive interview that future waves of CCGs undergoing authorisation were likely to include some given ‘level four conditions and above’.

Wave two CCGs are due to be announced on Wednesday, with waves three and four following in the next two months.

CCGs can be authorised with no conditions, authorised with conditions or not authorised. The 34 CCGs in the first wave announced last month were all authorised, with the most severe condition given at level three, which requires certain decisions to be signed off by the Commissioning Board.

Dame Barbara said: ‘I think it is likely we will see CCGs with conditions of level four and above.’

Under level four conditions, the Commissioning Board places a specific team or individual on to CCGs. Level five would see the CCG’s accountable officer replaced while level six would mean some of the CCG’s specific functions would be removed.

However Dame Barbara rejected claims that level four and above conditions would erode CCGs’ autonomy. She said: ‘The whole of the authorisation process has been designed to be developmental but also designed to make sure that the commissioning of services are safe. The responsibilities of these organisations are massive.’

‘From a patient’s point of view, CCGs are going to be responsible for ensuring the vast majority of health services I need are going to be available and as a taxpayer, they are going to be responsible for a huge amount of money we all pay to make sure we have this NHS which is so precious to us and delivers services free at the point of need.’


Note: this article was updated at 12:08 on 23 January. The original article and headline said individuals or teams were to be imposed on to CCG boards. This was incorrect; the individuals or teams will be imposed by the Board to support the CCGs in this area.

CCG condition levels

1 - No action necessary
2 - NHS board will make advice/expertise available if needed 
3 - NHS board sign-off needed for specific decisions made by the CCG
4 - NHS board will place a specific team or individual on to the CCG
5 - CCG’s accountable officer will not be ratified and an alternative will be appointed          
6 - Specific functions will be removed         
7 - All CCG functions will be removed

Source: NHS Commissioning Board