A statement by the NHS Alliance/National Association of Primary Care’s (NAPC) Commissioning Coalition says there is a risk the NCB will replicate ‘more of the same’, not least because there has been little change at the top of the NHS. It points out that the old 'footprint' - 50 local offices plus four sector outposts - remains.
This adds to clinical commissioners’ concerns and perceptions that they will be suffocated, instead of liberated which the Coalition sees as fundamental to commissioning’s success.
The statement continues that the NCB will be led by the chief executive, medical director and chief nursing officer. ‘The proposals do not mention where primary care clinicians or clinical commissioners fit into its working,’ the statement continues.
NAPC chairman Dr Charles Alessi said: ‘What we are hearing and seeing are the same old messages and the same old structures, albeit with new nomenclatures. If we put the same ingredients into the mix, the likelihood is that we shall deliver the same inefficient environment and outcomes.
‘This is insupportable in an economy of tight financial restraint. Something will have to give. The Coalition will exert all its energies to bring about an environment in which clinical commissioning can thrive. This is our raison d’etre and we shall be tireless in our efforts to liberate our members.’
NHS Alliance chairman Dr Michael Dixon said: 'With most clinical commissioning groups (CCGs) seeing the NCB itself as their greatest risk at present, the NCB will now need to work much harder to convince primary care clinicians, clinical commissioners and CCGs and their leaders that they are not simply pawns in strategy of implementation or largely see 'business as usual'.'
A NCB spokesperson said: ‘We agree that CCGs will be critical to the success of the new commissioning system and have consistently said that we must support them to be the best that they can be. Moreover, we know that clinical leadership and expertise must flow through the new system, which will come from clinical networks and senates, and from the clinical leaders who will take up nearly half the senior posts in the organisation.
‘The NCB will account for the £80bn NHS budget with a 50% reduction in running costs on the current system - the proposed initial design builds on the existing geographical footprint to support the service through a complex transition process that affects thousands of roles and individuals. Now that initial structures have been agreed, we will continue to work with CCGs and their leaders, to build the organisations, relationships and behaviours that will drive the best outcomes for our patients.’