The final authorisation decisions for the 35 CCGs in the first wave of authorisation are due to be made by the NHS Commissioning Board (NHSCB) on 5 December. England’s 211 CCGs are due to take responsibility for commissioning once PCTs are abolished next April.
There are three authorisation outcomes for CCGs. The first is 'authorised', the second is 'authorised with conditions' and the third is 'established but not authorised'.
Shadow CCGs which are 'established but not authorised' will have the same legal status as CCGs authorised with conditions and are still statutory bodies. But they would not able to carry out their statutory duties.
In this case, the NHSCB could carry out the CCGs’ duties but the NHSCB said it will only do this if local arrangements could not be made with neighbouring CCGs.
The NHSCB’s head of authorisation Dr Sarah Pinto-Duschinsky said: ‘The authorisation process for CCGs has three possible outcomes. A CCG can be authorised outright, authorised with conditions or established but not authorised.
'In the event that a CCG is established but not authorised and exists in shadow form, then the NHSCB will consider whether its functions can be provided by neighbouring CCGs or whether a support package from the local Commissioning Support Unit can be put in place before the board directly steps in to handle local commissioning functions.’
The authorisation process includes an authorisation application and a site visit. The NHSCB’s authorisation panel discusses the feedback from the site visit and submits its recommendations for authorisation against 119 criteria.
The authorisation panel then submits its recommendation to a conditions panel to consider what support is required where a CCG has not supplied sufficient evidence to meet a threshold for one or more authorisation criteria. The panel makes a report and the CCG has a fortnight to comment, including providing any new evidence that obviates the need for a specific condition. A sub-committee then makes the final authorisation decisions.
Key dates in the authorisation process
