The NHS Commissioning Board has published a draft framework to govern CCGs working collaboratively with other CCGs to enable them to look beyond their own local commissioning role and ensure quality, access and outcomes requirements are met. The draft framework promises a Model Collaborative Agreement in September.
The current draft framework is limited in scope to intra-CCG collaborations, but further guidance will be provided to address collaborations with other organisations, such as local authorities, with which CCGs will need to collaborate on joint and integrated commissioning arrangements.
This draft framework covers not only collaborations between groups of neighbouring CCGs who share a main provider, such as a District General Hospital, or a large number of CCGs working together across a wide geographical area, eg, to commission an ambulance service, but also a small number of neighbouring CCGs commissioning a specialist low volume service from a single provider.
Preparatory arrangements for collaborations are to be completed by the end of October in readiness for the 2013/14 planning round. CCGs will need to decide whether, in seeking to act in the best interests of their patients;, the undoubted benefits of collaboration, such as more effective contract performance management and the sharing of expertise, will outweigh the desirability of involving member practices of the CCG directly in all decision-making.
The focus of the framework is on the legal requirements for collaborative commissioning across CCGs and the special considerations that need to be taken into account – see Annex 1. These requirements will dictate steps that will have to be taken in the run up to authorisation and so are highly relevant during the current period of preparation for statutory body status. The NHS Act 2006 (as amended) will give CCGs the legal power to collaborate with other CCGs. However, regardless of any collaboration arrangements which may be made using that power, each CCG remains accountable for commissioning services that meet the needs of its population and for ensuring that all relevant quality standards are met.
Any delegated arrangements for the exercise of a CCG function must be set out in the constitution of the CCG, which is why the arrangements that will be put in place need to be thought about now before the constitutions are finalised and the CCG is authorised.
CCGs are required to have met their authorisation requirements by the end of October 2012 in time for the start of the 2013/14 contracting round and to ensure that new arrangements can be put in place by the time CCGs assume their functions as statutory bodies.