Commissioning board encourages CCG contract and risk sharing
The NHS Commissioning Board has published guidance highlighting the benefits of - and options for - clinical commissioning groups collaborating to share contracts with providers and pool financial risk.
A draft of A framework for Collaborative Commissioning between Clinical Commissioning Groups, produced with NHS Clinical Commissioners, was published on Friday.
CCGs are required to have considered collaborative working as part of the national CCG authorisation process.
The guidance says arrangements must be in place by October “in time for the start of the 2013-14 contracting round”. It sets out several models for collaboration, which CCGs can choose from.
The guidance says CCGs must “decide which contracts and services the CCG would want to collaborate on”, “determine which other CCGs they will collaborate with in which instances” and “agree with the other CCGs in the collaborative, the approach they will take, the model they will use and what each CCG will contribute”.
They must also “determine what, if any, additional support might be needed for example from a [commissioning support service] and determine how this will be funded”, and “design, agree and implement the governance arrangements that enable the collaboration and ensure these arrangements are reflected in their constitution, plans and structure”.
The guidance suggests different approaches: “Where two or more CCGs commission a single service they could work together to ensure consistency in quality for their patients. In some cases, a large number of CCGs might commission a single service that is organised across a large geographical area (such as ambulance services) and in other cases, a group of CCGs who are geographical neighbours may wish to work together on a contract with a single provider to which the majority of their patients flow.”
The guidance does not suggest CCGs will be required to create a funding “risk pool” to help groups which overspend, either with other CCGs or with the commissioning board. However it says: “The CCGs may wish to consider whether they will share or pool risks, particularly in respect of financial and activity deviance, and agree how this will be managed.”
It sets out benefits of collaborating in three areas: clinical improvement; efficiency - including “leverage with providers”; and resilience and risk management - including “enabling diversity in CCG configuration and size”,” managing financial risks”, and “managing regulatory and legal change”.