CCG barometer: Mix of confidence and concern

The first clinical commissioning group barometer of the new financial year presents a mixed picture of confidence and concerns from NHS commissioners, and some messages for the politicians ahead of the general election.

The NHS Five Year Forward View has been well received and CCGs have a high level of confidence that they can implement new models of care within the next two years. One challenge for them will be whether politicians, both locally and nationally, will back those new models of care if they result in local services being downgraded, facilities being closed or the greater involvement of independent sector providers in local health services. In order to deliver successful service transformation, CCGs will need political support as well as robust consultation and decision making processes.

‘If HWBs are to have a more central role, the next government will need to invest in their development’

There is a clear message for Labour: that if it wishes to increase the role of health and wellbeing boards in health commissioning, it risks losing the involvement of GP commissioners. Other concerns with this policy direction include political priorities being placed ahead of patients, and the wide variation in the maturity and effectiveness of HWBs.

If the wellbeing boards are to have a more central role, the next government will need to invest in their development and also consider whether their NHS constitution should do more to balance political and patient concerns.

Procurement and competition remain concerns to many CCGs, and nearly half of respondents said they have invited competition for services because of concerns about compliance with competition rules rather than because they believe it will improve patient outcomes. At the same time, nearly 80 per cent of respondents said their commissioning costs have increased as a result of procurement, patient choice and competition.

These CCGs may take some comfort from election pledges from Labour and Liberal Democrats to repeal the competition provisions of the Health and Social Care Act 2012. However, given the primacy of European law in public procurement, it may be difficult to reduce the burden significantly.

Peter Edwards is senior partner at Capsticks