UPDATE COMMISSIONING CONDITIONS
M A K I N G T H E G R A D E
With a large number of CCGS still facing conditions before complete authorisation, how does the land lie for the newly appointed bodies? GEORGE CAREY looks at the story so far and asks what is being done to get them to standard
T
he day of reckoning has come and gone and clinical commissioning groups are now officially in charge of services in their respective
areas as part of the £65m commissioning budget. Despite the years of hard work and many extra stress-related grey hairs involved in making the transition, some felt underwhelmed by the long awaited change. None more so than Wigan’s commissioning group, which tweeted: “It’s the second day of the new NHS and it’s already business as usual at Wigan Borough CCG. #NHSreform.” However significant the actual reform will prove to be, there are still considerable hoops for many CCGs to jump through before they can start making changes – or not, as the case may be.
Now operating under its new moniker, NHS England, the board has now fully authorised another 63 groups after reviewing conditions imposed on the first three waves of CCGs. This means that as it stands, 106 of the 211 groups enjoy fully- authorised status, while 105 still have work to do, after failing to meet in full the 119 authorisation criteria. There is some good news for those not yet making the grade, with 47 of that number having formally discharged some of their conditions, while two have had legal directions lifted from their authorisation. Of those CCGs with remaining conditions, over half (55 out of 105) have fewer than five conditions. Tougher times lie ahead for the 14 CCGs that have been authorised with legal directions, meaning their conditions are underpinned by legally-mandated support
from NHS England or another CCG. The conditions review process has also resulted in a legal direction being added to one CCG’s authorisation, and to some conditions being upgraded from level two to level three, meaning the CCG must receive additional sign-off from NHS England for some areas of its work.
Of the 119 criteria CCGs must meet, there were two the CCGs failed to satisfy far more commonly than any others: having a clear and credible plan that sets out draft commissioning intentions for 2013/14 and a high-level strategic plan for 2014/15; and having a detailed financial plan setting out how the CCG will achieve financial balance and operate within its management allowance. The core challenge is to commission improved services for patients in a time of financial stringency, and there
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