CCG Barometer: 'Weak support' a major concern for clinical commissioners
Weak support services could be one of the greatest barriers to clinical commissioning groups’ success and undermine attempts to control spending, CCG leaders fear.
HSJ’s CCG Barometer survey asked leaders to rate potential barriers to their effectiveness as an organisation in the next year.
The most widely cited barriers were the national £25 per head limit on administration costs, followed by having a weak commissioning support unit, with 81 and 67 per cent or respondents respectively naming them as barriers. However, few CCGs appear poised to abandon their unit.
Asked whether their CCG might move a significant amount of commissioning support in-house in the next year, 20 per cent said it was likely and just 6 per cent very likely.
Nineteen per cent said they were likely to re-contract a significant amount of their support to alternative providers. Two per cent said they were very likely to do so.
NHS Kingston CCG accountable officer David Smith warned that many group leaders were concerned about their support units being under-developed as they begin contracting for 2013-14.
He said: “CSUs are really critical as they are going to be managing our acute budget. We are in the middle of the transition, and we are entering the next contracting round. A lot of people are concerned about that risk.”
Mr Smith said if support units did not prove themselves, CCGs would look for alternatives, but “if they can deliver I can’t see why they can’t be as effective as going to the market”.
Johnny Marshall, a GP and senior member of CCG representative body NHS Clinical Commissioners, said support units were a “pivotal part of the success of CCGs” and the survey showed they needed to “ensure they are raising their game” in providing what CCGs wanted.
Another factor leaders identified as a likely barrier to CCGs’ effectiveness was engagement of their member GP practices.
NHS Vale of York CCG accountable officer Mark Hayes said it was a challenge for many groups to “convince the bulk of GPs this is something they’ve got to get on board with, and which will benefit their patients”.
NHS Commissioning Board director of commissioning development Dame Barbara Hakin said the lack of confidence could be because CCGs were only now confirming the funding for NHS support units, so they have been slower to develop and employ staff.
Dame Barbara said: “CCGs recognise that support units are, like themselves, on a journey.” She said CCGs had been told to finalise funding by the end of this month, which would put the units “in a very strong position to move faster”.
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Readers' comments (4)
Robert Varnam | 8-Nov-2012 1:10 pm
It's also important for CCGs to consider what they're asking member practices to engage in, and how meaningful it feels. There aren't many practices who are keen to commit to being reps - but it's easier to get commitment to being collaborators in improvement. Meaningful engagement also means not 'doing' engagement as a bolt-on activity, but 'being' engaging, as a culture and habit.
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FRANK FITZPATRICK | 8-Nov-2012 1:32 pm
How have CSU's become such a part of this whole mess? Dismantling PCT's and SHA's shouldn't have meant inventing another layer to replace them. Already CSU's wage bills are replicating or outstripping their previous equivalents. Having CSU's report for pay and condistions to the NHSBSA when everyone knows they take their lead from the CB is dishonest.
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Concerned-Escapee | 8-Nov-2012 2:17 pm
Re Frank's comment : the layer of CSU is essential for 3 reasons . Firstly GPs, who function at the gut instinct level, do not know how to behave as responsible public servants and require the leadership of officers to pull them into line with CB expectations ; secondly CSUs are surely an effective channel for national policy and acceptable codes of behaviour and are large enough to promote a culture of compliant behaviour; thirdly, CSGs have shed much of the PCT know-how, and have to start again to learn how to commission and procure safely. I guess the whole thing is a bit like using steel buttresses to secure a badly designed building - it is inevitable once the foul deed is done.
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Anonymous | 13-Nov-2012 2:44 pm
Odd choice of headline HSJ when the tables above clearly show that the largest concern is the cap on admin costs?
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