A recent major announcement was the unveiling of the newest “coalition” on the block: a joint project between NHS Alliance and the National Association of Primary Care (NAPC) to provide a strong voice to champion clinical commissioning and clinical commissioning groups (CCGs). The alliance has been formed in response to the clear need for a single organisation to support the development of clinical commissioning and back the cause of emerging CCGs.
Currently, NAPC and NHS Alliance are alone in wholeheartedly supporting the concept of clinical commissioners. In future, through the establishment of the coalition, they will become the independent, collective voice of CCGs. Both NHS Alliance and NAPC will continue to exist as distinct, independent organisations which will pursue their own aims and agendas in respect of other functions that are not relevant to commissioning or CCGs.
The coalition has agreed a number of shared principles:
- NHS commissioning should be a public function exercised by statutory bodies in the public sector alone. NHS commissioners themselves should be free to choose the support they need from whatever source they feel to be appropriate.
- The NHS should be based on an approach which maximises local responsibility and ownership through local determination rather than central direction and that the NHS Commissioning Board should do only those things that must be done at national level.
- CCG Boards should have GPs as majority members with a strong primary care focus. Boards will need to ensure the appropriate involvement of other clinicians and managers and have strong representation from local communities and independent directors.
- NHS provision should be appropriately distributed across the public, third and independent sectors according to the public interest. Competition is a means to an end and not an end in itself. Those providing NHS services should clearly subscribe to NHS values of openness, transparency and accountability and behave in a manner consistent with those values.
- The NHS should develop integrated care, both vertically and horizontally, centred on the needs of the patient rather than the providing organisations, supported by appropriate payment systems.
The coalition’s priorities are:
- Lobby the Government to review the role and power of NHS Commissioning Board to ensure that it is set up as an organisation that enables rather than controls CCG’s work.
- CCG’s self-determination: clinical senates, clinical networks, and local health and wellbeing boards should help not hinder CCGs, who must be the final decision makers for their patients.
- Work with Government to ensure that aspiring CCGs do receive the funds intended to support their development.
- Oppose any suggestion that CCGs should be constrained in their choice of commissioning support.
- Monitor and the CQC should be required to demonstrate that they are acting in the public interest. The coalition will seek to ensure that CCGs have the means of challenging their decisions.
- Transparency: the coalition believes that the payment of any quality premium (to reward CCGs that commission effectively) should be transparent, represent good value for money and be in the public interest.