Papers published ahead of this week’s NHS England board meeting detail proposed tough measures to guard against conflicts of interest.
The report, written by national director for commissioning strategy Ian Dodge, said CCG decision-making committees would have a lay and executive majority and have a lay chair, putting control out the hands of GPs.
The measures, due to be consulted on if approved at Thursday's board meeting, would be put on a statutory basis.
The ‘significantly enhanced’ measures against conflicts of interest would also see enhanced training for lay members, public registers of interests and decisions, and observer rights for local authority and Health Watch representatives.
GPC conflict of interest concern
GP leaders have previously raised fears that co-commissioning would lead to conflicts of interest with GPs commissioning or contracting themselves and colleagues. GPC welcomed indications last month that the new powers would not extend to revalidation, performers lists and performance management.
The board paper also revealed that under co-commissioning local variations to national incentive schemes such as QOF would no longer require national approval from NHS England, allowing CCGs flexibilities to develop local schemes. NHS England would retain the power to impose national standing rules to ensure service consistency.
CCGs will be able to choose one of three models of co-commissioning: greater involvement, joint decision making, or delegated responsibility. Mr Dodge’s paper said a standard governance framework for joint and delegated commissioning arrangements would be developed, but more tailored models could be developed in 2016/17.
A document, Next steps towards primary care co-commissioning, will be published on 10 November providing CCGs with details on options available and setting out the national frameworks.
Local implementation will begin in March 2015 and go live on 1 April.