Small CCGs look set to merge after £25 per head management allowance

Small clinical commissioning groups (CCGs) look set to be forced to merge after the DoH confirmed groups would receive just £25 per head per patient for running costs.

Dr Ingram: The announcement would make it ‘even more difficult’ for small CCGs to function

The NHS Operating Framework for 2012/13, which was released on Thursday, revealed that CCGs would receive £25 per head ‘excluding ‘any entitlement to a quality premium’. The DoH previously said that CCGs would receive between £25 and £35 per head.

Dr Mike Ingram, who runs England's smallest CCG the Red House Group of practices in Hertfordshire with 18,900 patients , said the announcement would make it ‘even more difficult’ for small CCGs to function.

He said the CCG will be looking ‘very carefully’ at its options but said the group was ‘not dead yet’.

He said: ‘We feel rather like a kid in the playground being picked on by all the others. It’s the barrage of regulations, notifications and conditions coming out that seem unrelated to the ethos and principles under which the NHS reforms were first rooted.’

NHS Alliance GP Commissioning Federation national co-lead Dr Shane Gordon also wrote on Twitter that the confirmation of running costs would be a ‘major headache’ for small CCGs. He said this week that the issue of management allowances was keeping him ‘awake at night’.

Earlier this week the National Association of Primary Care and the NHS Alliance warned that CCGs covering a population below 100,000 would not be viable.

Londonwide LMCs chairwoman Dr Michelle Drage
CCGs will only have a third of the resource that PCTs used to have, which will leave them no scope to do commissioning effectively. We’re getting all of the rhetoric about the redesign of services but we don’t get given the resource to do it’.

GPC negotiator Dr Channd Nagpaul
It is disappointing that CCGs are expected to deliver more than PCTs with significant reduction in management resources. This will undermine the ability of CCGs to deliver on the governments aspirations. This allowance will be further eroded given that CCGs may have to rely on external commissioning support, which would be more expensive than if it was delivered in-house.

Wessex LMCs chief executive Dr Nigel Watson
This announcement will be critical for small CCGs. If you only have £25 per head to play with, by the time you have employed a few GPs and managers you are not going to have very much money left. If will mean CCGs will either have to work very collaboratively if they are small and share lots of functions or they need to be bigger and have really good devolution and autonomy at local level.

Former NHS manager Roy Lilley writing on his blog
It seems from 2013/14 GPs are going to have £25 per head to get their part-time commissioning boutiques up and running. Ouch! This definitely rules out the bridge-club consortia. If this is not a message that consortia will have to head for the 300,000 population mark or more, I don't know what is?

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