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The co-commissioning challenge

The co-commissioning challenge

The expectation is that now they have the power and influence they requested, CCGs will deliver joined up healthcare and much needed local flexibility, resulting in improved patient outcomes

Posted: 3 May 2016

Writer: Ross Ferguson, freelance writer

Set out in the NHS Five Year Forward View, co-commissioning is seen as a key enabler in developing seamless, integrated out-of-hospital care that breaks down barriers to meet the diverse needs of local populations. It gives CCGs the option of having more control over the wider NHS budget, which enables a shift in investment from acute to primary and community services. The focus for the moment is on GP services, however, it is anticipated that in time, this may extend to dental, pharmacy and eye services.

The basics

The CCG membership organisation, NHS Clinical Commissioners (NHSCC), which represents CCGs, had been calling for greater commissioning powers as detailed in its briefing document, Commissioning primary care: transforming healthcare in the community, to enable CCGS to provide integrated services.
In May 2014, NHS England invited CCGs to submit expressions of interest in taking on an increased role in the commissioning of GP services through one of three co-commissioning models:

* Level 1: Greater involvement – an invitation to CCGs to collaborate more closely with their local NHS England teams in decisions about primary care services to ensure healthcare services are strategically aligned across the local area.

* Level 2: Joint commissioning – enables one or more CCGs to jointly commission general practice services with NHS England through a joint committee.

* Level 3: Delegated commissioning – offers an opportunity for CCGs to assume full responsibility for the commissioning of general practice services.

Little wonder then that in 2015/16, almost three-quarters of England’s 209 CCGs have taken on the role of commissioning GP services, with 63 CCGs taking on full delegated responsibility. In December 2015, a further 52 CCGs were authorised to take on delegated commissioning of GP services and will be able to operate under these arrangements from April 2016, meaning more than half of CCGs will have delegated responsibility in 2016/17, and it is expected that one-third of CCGs will be operating under joint arrangements.
NHS England is now encouraging all CCGs to consider applying for full delegation. But, what are the barriers, the conflicts and the benefits?

Join us tomorrow as we’ll be discussing conflicts of interest in co-commissioning