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NHS Commissioning Board sets out authorisation process for CCGs

The NHS Commissioning Board will ‘bend over backwards' to ensure that as many clinical commissioning groups as possible are authorised without conditions, the Government's commissioning tsar Dame Barbara Hakin has pledged.

The NHS Commissioning Board this week published new draft guidance for CCGs on the authorisation process, setting out the 119 criteria they will be examined on across six different domains. The guidance outlines four waves of authorisations, with the first one beginning in June and the final one ending by November, with CCGs undergoing the process being either fully authorised, authorised with conditions or formally established as a shadow CCG.

Dame Barbara, national director of commissioning development, said it was too early to say how many CCGs would fall into each category, but insisted the NHS Commissioning Board had no desire to CCGs fail.

‘The board dearly wants as many CCGs authorised with as few conditions as possible,' she told Pulse.

‘In everything we do we will be bending over backwards to have the maximum number of CCGs authorised with the minimum number of conditions.'

There is no limit on the number of conditions that can be placed on an authorised CCG, but Dame Barbara said they could include a more ‘mature' local CCG becoming temporary lead commissioner, specific management support for the CCG, or the NHS Commissioning Board retaining control of some commissioning decisions. 

Under the authorisation process, CCGs will have to submit figures for a ‘desktop review' and case studies to demonstrate how they will improve services. There will also be an analysis of local stakeholder views of the CCG and a site visit carried out by the NHS Commissioning Board.  

As revealed by Pulse last month, a clinical member of another CCG will take part in the site visit as part of the authorisation process.

Although CCG members will be able to query assessments made during the authorisation process, there will be no appeals process once a decision on authorisation has been made.

Dame Barbara said that ‘in an ideal world' CCGs would be split equally among the four authorisation waves, but that ‘there was some flexibility' if this did not happen.

‘There are no prizes for being in the first wave, and no penalty for being in the last wave,' she said.

‘We'll be asking CCGs who feel the most mature to come forward in the earlier waves, those that are still finalising structure are inevitably going to be in later waves.'

Dame Barbara said it was possible that structural changes to CCGs could take place in extreme cases during the authorisation process.

‘If a CCG was found seriously wanting and the Board could not safely authorise it even with conditions, then we would have to ask why,' she said.

‘I'm hoping there aren't any, but if there was one then we would have to consider the options.'