Exclusive: One in three 'inadequate' CCGs control commissioning of GP services

A third of England's worst-rated CCGs have been handed full control of commissioning primary care, a GPonline analysis reveals.

Ratings released last week by NHS England showed that in total, 26 CCGs were 'inadequate' while a further 91 were rated 'requires improvement'.

Of the 26 CCGs rated 'inadequate', eight have taken on fully delegated control of commissioning primary care - including management of GP practice contracts - from NHS England. A further nine share responsibility for commissioning primary care services with NHS England under joint commissioning arrangements.

Among CCGs rated 'requires improvement', 40 hold fully delegated control and 41 joint control of primary care commissioning.

Map: what is your CCG's rating?

Despite receiving the worst possible overall rating, most 'inadequate' CCGs received 'good' ratings for their handling of delegated functions. Just six scored 'requires improvement', while the rest were rated 'good' in this category.

Among CCGs rated 'requires improvement' overall, eight out of 91 were rated 'requires improvement' for their handling of delegated functions, while the rest received a rating of 'good'. The delegated functions category - one of five which inform a CCG's overall rating - was the only category in which no CCG scored worse than 'requires improvement'.

GPC deputy chairman Dr Richard Vautrey told GPonline that low overall CCG ratings primarily reflected NHS underfunding, and said that CCGs were likely to be at least as good as NHS England at managing general practice contracts and funding.

'The rating of CCGs is dominated by local funding deficits and it's a sign of the essential need to properly invest in the NHS as a whole. There's no evidence that NHS England has been or would be any better at managing primary care services than the local CCGs are,' he said.

Special measures

NHS England's report on ratings for commissioning organisations said it is 'taking action with each of the 26 CCGs rated as inadequate'.

The report said: 'CCGs rated as inadequate will be required to develop and implement a performance improvement plan under legal directions from NHS England.'

NHS England has made clear that nine CCGs placed in special measures could face a range of tough interventions, including 'adjusting a CCG’s area and membership practices, disbanding the CCG, requiring that a CCG shares a joint management team or creating an accountable care organisation'.

Photo: iStock

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