6 March 2012

NHS Clinical Commissioning Coalition: Commissioning Support Survey

In January 2012, the National Association of Primary Care (NAPC) and the NHS Alliance (NHSA) issued a short survey on commissioning support for Clinical Commissioning Groups (CCGs). The following press release highlights some interesting aspects of the results.

Altogether, there were 95 responses received from across the four strategic health authority clusters:  NHS London (12.6%); NHS North of England (33.7%); NHS Midlands and East (32.6%) and NHS South of England (21.1%).

In general terms, more than four fifths of respondents expressed dissatisfaction with the rolling out of the programme of commissioning support, and less than a fifth said they were content.  Specifically, 84.2% of respondents indicated they had not been given sufficient information about the choices of support available and would welcome more.

A further 70.7% expressed dissatisfaction with the commissioning support being offered.  And, worryingly, 20% indicated they had decided to use their local PCT cluster offering because they were too busy to explore alternative arrangements. 

However, 26.7% of respondents also indicated they had opted to go with the PCT clusters’ offering because relationships with PCT support staff were good.  Another respondent expressed strong approval for the quality of PCT support work and indicated excellent relationships, but feared the PCT cluster’s offering would be unaffordable.

Dr Charles Alessi, a senior figure in the Clinical Commissioning Coalition, commented: ‘This survey is just a snapshot of what is taking place locally around the country.  Overall, the results do not inspire any confidence in the manner in which the clinical commissioning reform agenda is being rolled-out, nor, specifically, in the fact that CCGs are being allowed to exercise the very judgement that will be needed to meet the challenges of the NHS modernisation agenda.  Although, in some parts of the country, a minority, genuine and mature relationships are developing between the PCT clusters and clinical commissioning groups, which we very much welcome.  Hopefully, we shall be able to draw on some of the lessons from groups.

‘The Health and Social Care Bill was intended to liberate clinicians to work with their patients.  But the reality, as the implementation agenda unfurls, is that what we are seeing here central control, which is incompatible with the intentions of the Bill.  Clinicians must be given the scope to determine with whom they work and at what price.  The propositions, being put forward in some Strategic Health Authority clusters, will severely restrict CCGs ability to transform and modernise care.

‘As the Coalition, NAPC and NHS A will be voicing its concerns with the top of the office team at the Department of Health.  Unless our concerns are addressed, the NHS will no longer be able to offer care to all free at the point of delivery across the range of services currently available and this country will regress in terms of the quality of care it offers and its status among first world Western countries.’

Dr Michael Dixon, another senior figure in the Coalition, added: "We must get this right as soon as possible. Clinical Commissioners should be treated as intelligent customers not, as happens in some areas, as servants of their commissioning support. Furthermore, they should be able to get the right quality of commissioning support and have proper choice of who will provide that. Only in that way will clinical commissioners and their patients get the support that they need. It is also crucial that we get this right from the very beginning if we are to allay fears expressed by other organisations that commissioning support will come to dominate and influence decisions that will need in future to be made by the clinical commissioners themselves"

Notes:

  1. NAPC and NHSA are working collaboratively on creating a collective voice on behalf of CCGs. They remain as two independent organisations working together on a common agenda in coalition with each other and there are no plans to merge.They are working on creating an interface arrangement between the two organisations that provides something more tangible with which all CCGs can identify. Through this interface, CCGs will be able to contribute to the development of a legitimate collective voice, as we seek to shape the future of the NHS Commissioning Board and commissioning arrangements.
  2. For more information, please email pressoffice@nhsalliance.org or call 07772756674.