DoH reveals clinical commissioning group authorisation details

Clinical commissioning groups (CCGs) will be required to undertake a risk assessment by December 2011 in order to become authorised, a draft government document reveals.

A risk assessment aims to help CCGs establish whether they will meet the criteria of authorisation

A draft DoH document, Developing clinical commissioning groups: Towards authorisation, outlines the requirements for CCG authorisation.

By April 2013, the whole of England will need to be covered by established CCGs, the document says.

By this date CCGs will either be fully authorised and responsible for commissioning activities or operating as ‘shadow’ CCGs, legally established but working in shadow form.

The NHS Commissioning Board will take on the commissioning responsibilities of shadow consortia that have decided they are not yet ready to take them on themselves.

The first ‘phase’ of authorisation will be a risk assessment of all CGGs, to be completed by December 2011.
‘It is proposed that the first phase is a risk assessment of the proposed ‘configuration’ of a CCG,’ the document said.

The assessment aims to help CCGs establish whether they will meet the criteria of authorisation.

Four key areas of CCG activity will be assessed. These include signup from member practices and geographical coverage.

Where CCGs straddle upper-tier local authority boundaries this must be for patient interest reasons.

Finally the assessment will look at the impact the CCG's proposed configuration will have on its ‘organisational viability’, the document says.

CCGs are invited to have an initial risk assessment as soon as possible, starting from October 2011, allowing them to become authorised more quickly.

The document lists the areas in which CCGs would be assessed prior to authorisation. However the document stresses that the list should be used as  a ‘developmental tool’ and not as a list of tests for authorisation.

Prior to authorisation CCGs will need to demonstrate:

  • A strong clinical and professional focus which brings real added value;
  • Meaningful engagement with patients, carers and their communities;
  • Clear and credible plans which continue to deliver the QIPP (quality, innovation, productivity and prevention) challenge within financial resources, in line with national outcome standards and local joint health and wellbeing strategies;
  • Proper constitutional and governance arrangements, with the capacity and capability to deliver all their duties and responsibilities including financial control as well as effectively commission all the services for which they are responsible;
  • Collaborative arrangements for commissioning with other CCGs, local authorities and the NHS Commissioning Board as well as the appropriate external commissioning support; and
  • Great leaders who individually and collectively can make a real difference.

At the point of authorisation, the NHS Commissioning Board will take the final decision on configuration. This will take into account the results of a '360 degree assessment' which considers the views of stakeholders, the document says.

CCGs will be offered support from their local PCT cluster, SHA clusters and local authorities throughout the authorisation process.

A DoH spokeswoman said:  ‘CCGs are at the heart of our NHS modernisation plans.

‘This initial thinking, which has been developed by a range of stakeholders, represents our preliminary proposals for authorising CCGs.

‘This will support emerging CCGs in their development and enable them to be as prepared as possible for authorisation as well as taking on responsibility for healthcare budgets and improving services for their local communities.’

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