CCG populations 'should exceed 100,000'

Clinical commissioning groups (CCGs) should not have populations of less than 100,000, according to an NHS London director.

Map showing 257 clinical commissioning groups (CCGs); colour denotes NHS region
Map showing 257 clinical commissioning groups (CCGs); colour denotes NHS region

Speaking at a National Association of Primary Care (NAPC) meeting in Paddington, west London, on Wednesday evening, Hannah Farrar, NHS London’s director of strategy and system management, said CCGs were budgeting on £25 per patient funding.

All would have fixed costs common to all statutory bodies, including for audit and governance, and subtracting this from their funding left CCGs in London with an average of £20 per patient, varying between £3 and £23 depending on their size.

Asked what was the lowest population at which safe care was possible, she said: ‘If it’s less than 100,000 population, I think you are going to really struggle to get the calibre of support needed.’

Speaking at a joint NAPC/NHS Alliance event in Westminster, central London, on Wednesday afternoon, commissioning czar Dame Barbara Hakin called on groups with considerably less than the average populations of 200,000 to help the DoH find out what the fixed costs they faced were and how much funding might be available to them after this had been subtracted to do the work that they would like to. The DoH has launched a ready reckoner for CCGs to help with this.

Dame Barbara said: ‘There is a point when you do the calculation that the fixed costs of statutory bodies mean you have nothing left to do the things you want to, like changing clinical practice.

‘There are different ways that people can work together. You can be in a locality without being a statutory body,’ she added.

She said bodies which could prove they could significantly improve care for patients would not necessarily need to share boundaries with local authorities.

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