PCT clusters will be retained in their current form beyond 2013 as outposts of the new NHS Commissioning Board, in order to commission GP services and oversee new clinical commissioning groups, the chief executive of the NHS has revealed.
But Sir David Nicholson stressed that the move would not merely represent a re-creation of existing PCTs, reminding staff that the new arms of the board would require 'significantly less capacity' than is currently the case.
In a letter to NHS managers outlining the next steps for the Government's controversial reforms, Sir David also announced plans to merge the 10 SHAs into four clusters from this October, mirroring the process that has seen England's 151 PCTs merge into 50 slimmed down management teams across England. The new SHA clusters will retain statutory roles until the handover to new clinical commissioning groups (CCGs) in 2013.
The letter also disclosed that the new local arms of the board would commission 'some or all services instead' if a CCG is not ready to assume full control, and said the authorisation process would include 'a 360 degree process' whereby health and wellbeing boards, clinical networks and senates will have a say in determining whether each new commissioning body is ready to take control.
Sir David wrote: ‘The 50 PCT clusters are now in place and operational. The areas covered by PCT clusters will be reflected in the initial arrangements for the local arms of the NHS Commissioning Board. These local arms would be able to commission some or all care on behalf of those commissioning groups who are not yet ready to be fully authorised by April 2013.'
‘After April 2013, these local arms would oversee commissioning groups that have been authorised and would also commission some of those services, such as primary care, which are directly commissioned by the board.'
The letter also attempted to reassure NHS staff that the outposts of the board would offer them opportunities to retain employment, but admitted the scale of management cuts required would inevitably require many to look to clinical commissioning groups or commissioning support providers for alternative employment.
Sir David wrote: ‘It is important to be clear that the local outposts and other sub-national elements of the NHS Commissioning Board would require significantly less capacity than PCT and SHA clusters. So while aligning our geographical arrangements for the transition with our intentions for the commissioning board will secure opportunities for many staff, others in PCTs will still want to consider opportunities for moving to clinical commissioning groups or establishing commissioning support providers.'