NHS England will restrict CCG powers to performance manage GPs

GP leaders have welcomed indications from NHS England that CCGs will not be given powers over revalidation, performers lists and performance management under new co-commissioning arrangements.

NHS: co-commissioning plans
NHS: co-commissioning plans

NHS England said in a document outlining it proposals to hand primary care commissioning functions to CCGs that it had 'not detected an appetite ... to take on revalidation and performer’s lists'.

Many CCGs were also opposed to taking on individual and practice performance management aspects of contract management, the document revealed.

NHS England's thinking was to exclude these functions, it added.

Conflict of interest warning

The GPC has been warning against handing such powers to GP-led CCGs because of the potential conflicts of interest.

Deputy chairman Dr Richard Vautrey said the new position was in line with what the GPC had been calling for.

But he said the key concern was that CCGs may not have the resources to take on the delegated co-commissioning powers.

'NHS England didn't have sufficient resources to do it properly, and it's unreasonable to expect CCGs to do it without the necessary capacity,' he said.

The NHS England document also revealed that all but the worst performing CCGs will be supported to take on the new role. Only those with 'serious governance issues' or in a 'state akin to special measures', will be excluded.

CCG capacity questioned

Dr Vautrey said NHS England must ensure that all CCGs had the capacity and capability to perform their functions well, but that it itself did not have the capacity to do that. 'Their capacity is being reduced and I think what we do need is a fundamental review of what is actually required and what is unnecessary.'

Dr Vautrey said he thought NHS England's co-commissioning plans aimed to shift to CCGs responsibilities it could not afford to carry out itself.

Last month NHS England revealed plans for a cost-cutting reorganisation, merging its local and regional area teams to coincide with the roll-out of co-commissioning powers to CCGs.

CCGs will be able to choose one of three models of co-commissioning: greater involvement, joint decision making, or delegated responsibility.

Around nine out of 10 CCGs has bid for a role in commissioning primary care, and NHS England believes a third of CCGs are ready to take full control of primary care.

Local implementation will begin in March 2015 and go live on 1 April.

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