Clinical commissioning groups must become more accountable as they expand their role in delivering healthcare, the health secretary told a London conference yesterday.

Speaking at the Commissioning Show at the Excel centre, Jeremy Hunt said a more accountable future for CCGs would involve “taking responsibility for the entire delivery of healthcare for the populations that they represent and to show vision and leadership, based on capitation funding”.

He said NHS England’s invitation for CCGs to be involved in “co-commissioning” primary care would help realise this vision, as it would move them closer to controlling the budget for all healthcare for their populations.

NHS England was also examining giving CCGs greater involvement in commissioning specialised.

Jeremy Hunt

Jeremy Hunt suggested CCGs learn from systems in Spain and the US

Mr Hunt said that the shift he envisaged would involve the ability “to share electronic health records across the entire system”, giving CCGs better access to information.

“We absolutely need to get to a stage where we are able in real time to track the total health and social costs – including the social care system, primary care, secondary care [and] community care – for every single one of the individuals for which we are commissioning care in our areas,” he said.

The health secretary pointed to the internationally renowned health system of Valencia.

Under this Spanish region’s regime, single independent provider are contracted for long periods, making them accountable for almost all care of their populations.

Funding is provided by the state to the provider according to the population they cover instead of on the basis of the services they provide.

Mr Hunt said such an approach could create a “truly integrated system” and would be “made possible by the establishment of CCGs”.

The term “accountable care organisation” was created in the US and refers to a group of providers being contracted to jointly provide all care for a given population for a defined period, with their funding based to some extent on quality and efficiency performance.

However, HSJ understands Mr Hunt is not referring to CCGs becoming providers of care.