The authorisation of NHS commissioning groups will be an “iterative process” – with organisations able to correct their weaknesses throughout the process – government regulations have confirmed.
The regulations, laid before Parliament last week, said the NHS Commissioning Board’s process for considering clinical commissioning group’s (CCGs) applications must “allow for communication between the board and the applicant or applicants at all stages”.
The regulations say this will allow “clarifications to be provided either to the board or to the applicant on any matter related to the application” and “where appropriate for the applicant to adjust the application in light of communications with the board”.
As LGC reported last month, council chief executives are to be given a role advising the commissioning board on the authorisation of CCGs (21 June, LGCplus.com/5046126.article).
The first “wave” of 35 CCGs submitted their applications by the 2 July deadline, the board announced last week. A final decision on their authorisation – including whether they will be subject to any “conditions” – will not be announced until October.
However the CCGs are expected to receive feedback and reports throughout the process, and will be allowed to supply new information to the commissioning board.
GP and NHS Clinical Commissioners partnership director Johnny Marshall, formerly chair of the National Association of Primary Care, said this was the right approach, but warned that CCGs which are not ready should not be fully authorised.
He said: “It recognises that currently no one is an expert on clinical commissioning. There will be lots to learn along the way. It will be a developmental, iterative process. It should help CCGs to be able to be authorised without conditions.
“[However] there is no point in authorising people who are not capable of doing the job.”
The regulations confirmed that councillors would not be allowed to be members of CCG governing bodies, and that they must include at least one nurse from outside primary care, as revealed by LGC’s sister title Health Service Journal earlier this month.
They specified that the commissioning board must consult local authorities on the authorisation of CCGs but not clinical senates. In June last year, following the “pause” in its Health Bill, the government said the senate groups – expected to be composed of a broad range of clinicians – would have a “formal role” in authorisation.
Meanwhile, the board has published guidance about procedure for CCGs commissioning services where member practices may be the provider. It says they must consider whether others could be interested in providing them – and therefore using procurement or the any willing provider system – before awarding contracts to members.