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Are CCGs truly in control of their own destiny?

The NHS Commissioning Board has trumpeted the fact that every CCG in England has been authorised – firing the starting gun on a new world of a GP-led health service.

Everyone is more or less ready, we are told, but a quick look at the details of the wave four CCGs being authorised suggests that beneath the surface everything is not as it seems.

Some CCGs have been authorised in name only. A total of 15 CCGs will have ‘legal directions’ placed on them, meaning the NHS Commissioning Board will appoint troubleshooters to help them with certain functions.

Of these 15, three – NHS Basildon and Brentwood CCG, NHS Thurrock CCG and NHS Waltham Forest CCG  – will be unable to choose their accountable officers themselves and will even have specific functions removed.

The CCGs themselves are not necessarily to blame for needing this level of support. In the NHS Vale of York CCG, for example, the legal directions relate to the historic debt that it is inheriting from NHS North Yorkshire and York PCT.

Even in NHS Basildon and Brentwood CCG and NHS Thurrock CCG, there are historical reasons for the lack of engagement from practices and the huge number of conditions they are facing.

But the overall impression is that there will be far greater central involvement from the national Commissioning Board than the Department of Health promised, and many GPs would like.

There is no doubt these CCGs do need substantial levels of support – in the case of NHS Basildon & Brentwood CCG and NHS Thurrock CCG, support in every area of its responsibilities.

With just over two weeks until the reforms are implemented, it feels like a political decision to authorise every CCG, even when some do not seem ready.

Jaimie Kaffash is a senior journalist at Pulse