The job of the new NHS commissioning board (NHSCB) is not to tell CCGs what to do with the bulk of its role being to deal with primary and specialised commissioning contracts, according to the health secretary Andrew Lansley
Speaking at today’s NHS Alliance annual conference in Manchester, Mr Lansley said: ‘The job of the NHSCB is not to tell CCGs what to do or how to do it in the same way as nearly six years ago David Cameron and I said we ought to move to a NHS where we on behalf of the taxpayers are clear about what we are setting out to achieve, what are the objectives but we’re not going to tell it day by day how to do it.’
He admitted to a ‘hear and now transition’ period with SHAs and PCTs still having responsibility but said this was not indicative of how the eventual dynamic between CCGs and the NHSCB would be post-2013.
Jackie Little, a consultant at Barking and Dagenham CCG, told the health secretary: ‘We have been a successful PBC group for four years, now a successful CCG and are very, very passionate about taking forward clinical commissioning but now we feel that we are being dictated to by our local SHA. We’re being told our size is not right and that the constitution is not right’
Mr Lansley responded: ‘People will say “well hang on a minute how SHAs and clusters are acting now, is how they’re going to behave when they become part of the NHSCB after 2013.” This is literally not the case. The point of the legislation is that CCGs become statutory bodies on their own terms with their own constitution and their own GP practices. The relationship is different.’
He added: ‘The relationship with the NHSCB will increasingly be one which is that if you meet the initial authorisation criteria, then behave in a way which is entirely proper and demonstrate that you are responding to your statutory duties in continuously improving quality, addressing health inequalities then there is no basis on which you should be told what to do.’
He added only if a CCG was not demonstrating that it was meeting its statutory duties ‘should the NHSCB interfere with you’.
‘The bulk of what the NHSCB will do will be commissioning primary medical services and other contracts directly with GP practices and specialised commissioning and in setting as it were resource allocation and publishing on behalf of NICE as its advisory body clinical guidance and quality standards. It’s not about telling you what to do.’
In a earlier workshop at the same NHS Alliance conference, Tim Gilling, deputy executive director for the Centre for Public Scrutiny said there was a ‘tension’ for CCGs ‘between what the NHSCB tells them they must be doing and what the Health and Wellbeing Board says is important locally.’
Julia Manning, chief executive of think tank 2020Health said ‘My understanding is a dispute at that level would be referred to the NHSCB which seems to me not the best place to go.’