CCGs must have 'leverage' over primary care, warn managers

Clinical commissioning groups (CCGs) should have 'leverage over quality and value for money' provided by GP practices, according to an NHS Confederation report.

Mr Farrar: ‘We strongly welcome the creation of the NHS Commissioning Board. We want and need it to be successful.'
Mr Farrar: ‘We strongly welcome the creation of the NHS Commissioning Board. We want and need it to be successful.'

Powerful ‘incentives, rewards and sanctions’ should be established to drive CCGs to improve quality, outcomes, strategy and financial performance in local services, it added, but not at the expense of ‘distorting the patient-doctor relationship or clinical decision-making’.

The report said it is ‘essential’ that CCGs have a role in primary care development.

But it warned: ‘The fact that CCGs will not have formal responsibility for performance management of primary care weakens the potential for them to drive improvements in the part of the NHS dealing with the majority of patients.’

The report warned that the NHS Commissioning Board (NCB) may not be fully aware of the resources it will need to manage more than 8,000 GP contracts.

It recommends that the NCB should have ‘power to delegate to CCGs responsibility for managing contracts with GP practices’.

Under the current plans, the report said that too little was being done to take advantage of the opportunities the government’s NHS reforms offer to ‘drive improvements in primary care through strengthened local clinical leadership’.

Overall, the report said that the establishment of the NCB could solve a longstanding problem with NHS commissioning, but carried risks.

‘The absence of a national body that concentrates on commissioning has been a weakness for the NHS in the past,’ the report said.

But it warned that the Board would have to avoid widening its remit too far and undermining local commissioners.

NHS Confederation chief executive Mike Farrar said: ‘We strongly welcome the creation of the NHS Commissioning Board. We want and need it to be successful. If it isn't, the whole NHS is going to have a very big problem, especially with the current financial pressures building daily.’

The report called for clarity on how the NCB would convert NICE advice into commissioning guidance. This guidance should not be mandatory, but there should be a duty on CCGs to ‘explain their rationale’ if they chose not to follow it.

The role of clinical senates and networks should be made clear by the government, the report added. They should be advisers to CCGs based at the NCB, and not have a performance management role.

CCGs should have a say in appointing their members, the report added, and must not be held back by slow development of these groups.

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins


Already registered?

Sign in

Follow Us:

Just published

£20 notes spread out

VAT trap for PCNs could strip millions of pounds from general practice

Tens of millions of pounds could be stripped from general practice because work carried...

Talking General Practice logo

Podcast: Is the BMA representing GPs effectively, why GPs face a pension tax hit, and views on the workload crisis

In our regular news review the team discusses representation of GPs, a new survey...

Man sleeping

NICE guidance on insomnia backs app to replace sleeping pills

Hundreds of thousands of people with insomnia could be offered treatment via a mobile...

Health worker prepares a dose of COVID-19 vaccine

JCVI backs autumn COVID-19 booster campaign for high-risk adults and NHS staff

Frontline health and social care staff and adults at increased risk of severe illness...

GP consultation

Government accused of 'misleading' claims on general practice workforce

GP leaders have accused the government of making misleading claims about the general...

Consulting room door

LMC calls for enhanced access to be scrapped after abuse forces practice to close reception

A Midlands LMC has backed a practice forced to close its reception desk after abuse...