Clinical Commissioning Groups: An Overview
Since the implementation of the Health and Social Care Act (2012), clinical commissioning groups (CCGs) have taken over responsibility for commissioning the majority of NHS services in England from primary care trusts. Each of the 8000 GP practices in England is now part of one of the 211 CCGs. CCGs commission the majority of health services, including emergency care, elective hospital care, maternity services, and community and mental health services. In 2013/14 they will be responsible for a budget of £65 billion.
CCGs are responsible for commissioning secondary and community care services for their local populations and also have a legal duty to support quality improvement in general practice. In a recent report examining the development of CCGs, the King’s Fund pointed out that this second role has received less attention although it is vitally important if CCGs are to achieve wider objectives and deliver more integrated care. The report explains that the role of CCGs in supporting change in general practice is contentious and that policy regarding this has been unclear. Furthermore, CCGs do not commission primary care services and CCG leaders have no direct legal authority over clinical behaviour of member practices.
CONFLICTS OF INTEREST BETWEEN CCGs AND HEALTH AND WELLBEING BOARDS
Several specialist dementia units which provide full time respite and EMI care in Hastings, are facing closure or privatization... As well as being one of the Councillors for Baird Ward, I represent Hastings Borough Council at the Health and Wellbeing Board. The Board has espoused initiatives to localise healthcare and bring it under the scrutiny and control of local people. One of it’s’ responsibilities is to advise where to direct funding in order to reduce health inequalities and improve services. On its’ board are the Lead Member for Social Services, the Chair and Director of Adult Social Care, the Director of Children’s’ services, County Councillors and some local Councillors. I consider it to be of profound concern that all these individuals have ostensibly signed up to health initiatives which in their capacity as members of Clinical Commissioning groups (CCGs), many then actively undermine. Members of the Health and Wellbeing Board, including the Director of Adult Social Care, signed up to an initiative to improve dementia care for example. The same people then go away and put on a different hat and initiated a consultation to be brought before East Sussex County Council’s cabinet, to privatise dementia services at the Isabel Blackman Centre and close dementia units such as Mount Denys and Pine Hill. Both of the two units facing closure have been commended for their high quality of service and are frequently used by the NHS and private care providers as well as informal carers. They are extremely important in providing respite for the later…. I believe this affair not only calls into question the role and independence of the Health and Wellbeing Board, but a fundamental lack of democracy and transparency which characterises many of the changes occurring within Health and Social Care.