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Health commissioners could have powers removed

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Clinical commissioning groups may be given “support” including having managers imposed on them or their functions removed, it has been confirmed.

Health reporting HSJ and LGC logo

A report to the board says the chairs of authorisation panel visit teams - who will have a key role in assessing CCGs - will be chosen by the board’s operations director Ian Dalton.

Whilst the board has previously indicated it is more likely to send in teams of managers rather than take away CCGs’ responsibilities, the report confirms that removing functions and passing them to the board itself or a neighbouring CCG remains an option.

It says the conditions panel will “consider the expected duration of the conditions” and “in many instances it is anticipated” they may be removed by 1 April, when CCGs will take over from PCTs.

The NHS Commissioning Board was discussed the proposals along with details of the authorisation process for CCGs last week.

The board’s commissioning development director Dame Barbara Hakin told LGC’s sister title Health Service Journal it was important there was an element of moderation in the authorisation process. “It would be unfair on CCGs if there wasn’t a moderation group in exactly the same way as it would be unfair on students if there wasn’t moderation on GCSEs,” she said. “When you’ve got different examiners you need to make sure there’s national consistency.”

Panel teams will include commissioning board staff, senior primary care trust directors and “clinical leaders” from outside the CCG’s area. The first visits will happen in September.

Their assessments will be passed to a national moderation panel - chaired by Dame Barbara – before going to a conditions panel which will decide which conditions are applied to each CCG.

That panel will also “select from a range of support”. The report says details of conditions and “associated support” are still being developed but support will fall under seven categories. They are: providing a “model document/ toolkit”; making “advice/ expertise available”; requiring decisions to be approved by the commissioning board; “inserting/providing specific team/individual”; imposing a new accountable officer on the CCG; removing “specific functions”; or removing “all functions”.

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