CCG leaders could be sacked in authorisation process

The NHS Commissioning Board (NCB) could strip clinical commissioning groups (CCGs) of all their functions or replace their accountable officer if it decides they are not ready for full authorisation.

Dame Barbara Hakin: ‘The NCB will have to ensure that CCGs functions are carried out' (Photograph: P Hill)

The NCB is set to finalise plans for the CCG authorisation process at a board meeting on 19 July.

Under proposals revealed by the NCB, CCGs deemed not ready for full authorisation could be authorised with 'conditions'. These could involve supplying toolkits or staff to support their development, but could also involve the NCB having to sign off any decisions the CCG takes, the NCB ordering the CCG to take advice from a person or team, replacing the accountable officer, or stripping the CCG of some or all of its functions.

NCB national director of commissioning development Dame Barbara Hakin said authorisation deadlines would not be put back after the first wave of 35 CCGs all met their 1 July deadline for applications. The Board is due to make a decision on these in October and the second wave of 70 CCGs are due to submit their applications by 1 September.

Dame Barbara said the NCB would take on some of the functions for those CCGs which are authorised with all their functions removed.

She said: ‘The NCB will have to ensure that their functions are carried out and it may take on some of those tasks itself.

‘We have to have 212 CCGs established on the 1 April 2013. Hopefully they will be authorised without conditions.

‘The process was developed by working with CCGs, national primary care organisations and other stakeholders and has been designed to be fair, transparent, rigorous and efficient.

‘It must be robust enough to ensure CCGs meet the legal requirements for the establishment of new statutory organisations and are safe to proceed. But at the same time it must also balance rigour with a developmental approach.’

The NCB will visit CCGs as part of the authorisation process which Dame Barbara said will last more than a day. It will also include a visit from a respresentative from a local authority but not from the area where the CCG is based.

She said: ‘They are not there to talk about local issues. They are there as independent advisors.’

GPC deputy chairman Dr Richard Vautrey said those CCGs which are authorised with conditions should not be seen as a failure as there is an ‘unreasonably tight timescale’ to meet.

He said: ‘It will clearly be important to provide support to CCGs that need it once identified by the authorisation process. This should not be seen as a sign of failure but as the simply that they need more time, which is very understandable with this unreasonably tight timescale. Related to this it would be better to see a more explicit statement that this support could reasonably continue beyond 1 April 2013 for those CCGs that needed it. It is better to take time to get this right rather than rush and get it badly wrong.’

There are 67 CCGs in wave 3 which are due to submit their applications by 1 October and 40 in wave 4 which are due to submit their applications by 1 November.

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