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NHS to direct health commissioners

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The NHS Commissioning Board will have the ability to force clinical commissioning groups to work with centrally appointed groups of doctors on reconfiguration programmes.

Health reporting HSJ and LGC logo

LGC’s sister title Health Service Journal has learned that the board could impose “bespoke conditions” on CCGs’ authorisation, although one board source expected this power would only rarely be used.

A well-placed source said that bespoke conditions could be used in a variety of situations. They could include a requirement to recruit to a particular role or address an aspect of a CCG’s business plan, such as its financial assumptions.

If the board judged a CCG unable to deal with a local service reconfiguration, it could appoint a clinical team to oversee the programme and require the CCG to work with it, the source added.

Most conditions imposed by the board will be taken from a list of seven already published, starting with the issuing of guidance and progressing in severity to the removal of all functions.

HSJ also understands that, where a CCG is not authorised, the board would rather its commissioning functions are discharged by a neighbouring CCG or a commissioning support unit rather than taken on directly by the board’s local area team.

Meanwhile, the commissioning board has announced the timetable for CCG authorisation has been revised. The first wave of 35 CCGs will now be authorised in December, rather than November as previously expected. The delay is down to diary commitments of the directors sitting on the board’s authorisation sub-committee.

Waves two, three and four will be authorised in January, February and March respectively.

Julie Wood, interim commissioning development director of NHS Clinical Commissioners, said: “The commissioning board need to be very careful that in imposing bespoke conditions they don’t inadvertently stray into micro-managing how CCGs do their job.”

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