6 February 2012
Is the NHS Commissioning Board Really Being Set up to Liberate CCGs?
NHS Alliance/NAPC Clinical Commissioning Coalition’s response to NHS Commissioning Board update.
In the Department of Health’s original guidance Developing the NHS Commissioning Board (July 2011), Sir David Nicholson said: "CCGs will be the engine of the new system and things will only be done at a different level of the system where there is evidence that this produces better results."
Fast forward a few months and the Government’s document Design of the NHS Commissioning Board, released on 2 February, seems to be telling a completely different story. What we see are layers of bureaucracy and management, with complex guidelines. The old ‘footprint’, i.e. 50 local offices, remains there, plus four sector outposts, all using a single operating model.
There is a risk that the NHSCB will replicate ‘more of the same’, not least because many of the people involved in all of the ‘layers’ of the NHSCB, at sector and local office level, will be the same people – risking the same behaviours. This then adds to clinical commissioners’ concerns and perceptions that they will be suffocated, instead of liberated, which in our view, is fundamental to the success of clinically-led commissioning. In fact, in his July document David Nicholson had said that the new NHS “gives pride of place to clinical leaders”.
Unfortunately, clinical leaders do not feel that way. The NHSCB will be led by the Chief Executive, Medical Director and Chief Nursing Officer. The proposals do not mention where primary care clinicians or clinical commissioners fit into its working.
Dr Michael Dixon, a senior member of the NHS Clinical Commissioning Coalition, said: “The Clinical Commissioning Coalition takes the view that, with most CCGs seeing the National Commissioning Board itself as their greatest risk at present, the NHSCB will now need to work much harder to convince primary care clinicians, clinical commissioners and CCGs and their leaders that they are not simply pawns in strategy of implementation or largely see ‘business as usual’.”
Dr Charles Alessi, also a senior member of the NHS Clinical Commissioning Coalition, commented: “What we are hearing and seeing are the same old messages and the same old structures, albeit with new nomenclatures. If we put the same ingredients into the mix, the likelihood is that we shall deliver the same inefficient environment and outcomes. This is insupportable in an economy of tight financial restraint. Something will have to give. The Coalition will exert all its energies to bring about an environment in which clinical commissioning can thrive. This is our raison d’etre and we shall be tireless in our efforts to liberate our members.”
Ends.
Notes to editors:
- For more information, please email pressoffice@nhsalliance.orgor call 07772756674.