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CCGs may be ‘inadvertently stifled’ by pressure to balance books, warns Keogh

CCGs could be stifled by the ‘cold wind’ of financial pressures on them if they are not given enough freedom to innovate, the medical director of the NHS Commissioning Board has warned.

Sir Bruce Keogh told delegates at the Nuffield Trust’s Health Policy Summit 2013 that they were ‘doing their best’ at the board to ensure commissioners were given the scope to redesign care, but that he was concerned over the pressure on them to balance the books.

He also said secondary care must share the burden of reducing hospital attendance, rather than ‘building empires’.

He told delegates: ‘We’re doing our best to give the GPs freedom,’ he said. ‘I think what still niggles at me is that the cold wind of financial accountability will introduce a level of rigour which might inadvertently stifle some of the innovation we are actually trying to create.

‘That is an issue we discuss on a regular basis. It is an issue of concern for many CCGs. But if we as a commissioning board fail to give CCGs their freedom, then much of the structural change will have been of no value.’

He added that as around 40% of patients in hospital do not need to be there, commissioners should look to incentivise hospitals to reduce their own activity.

Sir Bruce said: ‘Aren’t there opportunities for giving hospitals incentives through the commissioning process to provide services out of hospitals?

‘The consultant who feels it is in his interests to build an empire sees, in conjunction with commissioning colleagues, that that empire can be built through the community rather than the ivory tower? That sort of approach will help.’