Next six months will be 'incredibly hazardous' for NHS, commissioning chief warns

The next six months will be 'incredibly hazardous' for the NHS in England, the head of two Commissioning Support Units (CSUs) has warned.

Mr Stout: managers must ensure NHS is secure by April
Mr Stout: managers must ensure NHS is secure by April

David Stout, chief executive of Hertfordshire and Essex CSUs, said commissioners faced an 'absolute critical task' in the run-up to April.

‘Phase 1 is keeping the wheels on the bus and then it is making the reforms work and achieve what we need to achieve,' he said. 'The next six months are incredibly hazardous in the NHS.’

Mr Stout, former deputy chief executive of the NHS Confederation, made the comments at a Westminster Health Forum event in London. The event focused on independent and third sector involvement with clinical commissioning groups (CCGs) and commissioning support services.

Mr Stout said health mangers had to ensure that the NHS was in a secure form by April, when PCTs are abolished.

‘We have thrown the commissioning system up in the air, we have established new commissioning organisations, not just CCGs but the NHS Commissioning Board (NHSCB),' he said.

‘The task in the next six months is to land this commissioning round safely. That is the absolute critical task. It means in this period of transition we will have to be flexible and realise we may have got some details wrong. But we need to make sure that it is in a form that is secure and lives within its financial resources.'

‘To do that they [CCGs] need to engage front-line clinicians in a way that PCTs never did.’

Mr Stout said that, if GPs viewed colleagues working on CCGs as 'going to the dark side', then the CCG had failed. On CCGs he said: ‘They have the trust of their GPs. If GPs see the leadership of the CCG as nurses or doctors going to the dark side, then it has failed.

He also warned that there was a ‘huge uncertainty’ in the system. This was happening at a time when commissioning responsibilities were getting tougher as a result of the Quality, Innovation, Productivity and Prevention (QIPP) programme, he said. QIPP represented ‘a huge challenge’, he argued.

‘The commissioning responsibilities are getting tougher and tougher in the years ahead. Adding to that we have created huge uncertainty for NHS staff,' he said. 'They are going in multiple directions, not to just CCGs, but to CSUs, local authorities or the NHSCB, or to retirement. That has put a lot of pressure and uncertainty on staff.

'While the structure of the NHS has been worked through at the middle, lots of the policies have yet to be worked through. Lots of the details are being worked on as we go. It is not a problem necessarily but it means there are not answers to questions we want to have answers to now. So that puts more uncertainly into the system.

‘CSUs are going to have to be fast moving and more flexible than the NHS traditionally has been. I am optimistic that we can make this system work.’

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