Clinical commissioning groups will have to manage on management allowances of far less than the nominal £25 per head per year and could struggle to afford the cost of large-scale procurements, it has has been warned.
Dr David Jenner, GMS/PMS lead for the NHS Alliance said that the management allowance figure of £25 per head per year revealed in the NHS Operating Framework 2012/13 was a “ceiling” figure and that many CCGs were having to operate on far less due to local circumstances.
The Operating Framework, published in November said: ´From 2013/14, the running cost allowance for CCGs is expected to be £25 per head of population per annum: this is before any entitlement to a quality premium. ´
Dr Jenner, a GP in Cullompton, Devon said the £25 had to cover the cost of primary care commissioning among other expenses. This meant even large CCGs could find it difficult to function.
He said his local CCG which will cover a population of over 800,000 was operating on a management budget of only about £18 per head per year.
´Once you´ve paid for public health and primary care contracting, that´s all that´s left.
´The actual management allowance is going to be different all over the country. Even with us getting very big. We´re going to struggle – particularly if we have to get tied into lots of large-scale procurements. We think our CCG board alone could cost £800,000 to £900,000 a year to run.´
David Stout, deputy chief executive of the NHS Confederation said: ´I´m pretty sure it is a guaranteed number but presumably the CCG is not obliged to use it all for running costs. I´m absolutely sure no one would quibble if they spent some of it on services. In that sense, the £25 figure is a cap´.