Board papers for a 3 July NHS England meeting show that 183 out of England’s 211 CCGs have bid for a role in commissioning primary care.
Some CCGs have bid to take complete control of commissioning primary care services from April 2015 after bidding for ‘delegated commissioning’ powers rather than a co-commissioning role.
In May, GP leaders at the LMCs conference in York voted to oppose co-commissioning of primary care by CCGs, warning of ‘unacceptable’ conflicts of interest.
Regional bids for primary care commissioning
Across the London and South of England regions, just three out of 82 CCGs chose not to bid for a role in commissioning.
In the North region, 57 out of 68 CCGs bid for a commissioning role, while in the Midlands and East 47 out of 61 have done so.
NHS England’s board papers reveal that three types of bid have been made:
Category A: greater CCG involvement in influencing commissioning decisions made by NHS England area teams.
Category B: joint commissioning arrangements.
Category C: delegated commissioning arrangements.
Category A involvement is considered ‘good practice’ and requires no formal process to establish.
CCGs granted approval for category B commissioning roles will be expected to set up a ‘committee in common’ jointly with NHS England to share decision making. The primary care budget will remain on NHS England’s books under this arrangement.
Full delegation of control
However, for CCGs that have bid for full delegated primary care commissioning powers – category C – the primary care budget will be delegated completely.
‘Category C will require a comprehensive assurance process to satisfy NHS England that the CCG has the capacity and capability to undertake this additional role, that the evidence of expected benefits to patients is clear, and that CCG governance arrangements, particularly in relation to conflict of interest, are robust,’ NHS England’s board papers reveal.
NHS England expects to approve bids for CCG primary care commissioning roles in October, with any delegated budgets transferring to CCGs from April 2015.