'We need to build the proper foundations for clinically led commissioning'

Would you buy a house unseen in an area you didn’t know, based simply on an estate agent’s blurb? And would you consider letting that estate agent choose your solicitor and surveyor? Of course not. You would go online and do your research; Google-mapping, social networking; looking on comparison websites.

You would become something of an expert on that area and that property and possibly even master some of the broader points of conveyancing. No one would be mad enough to take such a big step unprepared.

Yet, if we are not careful, clinical commissioning groups could be about to take a whole set of potentially unsupported steps, blindfolded and on the edge of a precipice.

Everyone acknowledges that a considerable pool of expertise will be needed before GPs can undertake their full commissioning responsibilities from 2013. Yet most GPs will admit to having a very limited understanding of the finer points of contracting or market analysis or estates management.

Help is at hand. GPs can buy all the expertise they need from the new commissioning support units or hubs being developed up and down the country.

But this has the danger of being no different from buying the house on the estate agent’s say-so. If the GPs do not know anything about contracting, how will they know whether the contracting service they are receiving is any good? In 18 months CCGs will be the authorised statutory bodies – not the support units. If they are not simply to become passive recipients of everything the units give them they must develop their skills as expert clients.

The popular image of CCGs as groups of maverick GPs operating in splendid isolation is not the reality. GPs work in partnership with managers, many of whom have significant commissioning experience. The ability of CCGs to operate as expert clients will ultimately come down to their managers working with their GPs to ensure support is put in place that will allow their local vision to be realised.

At Nene Commissioning we are clear that the opportunity before us is to transform and add real value to the commissioning process by putting clinical leadership at the forefront. This means influencing, directing and changing the way that commissioning is delivered, whether it is carried out directly by us or bought from a commissioning support hub.

We are putting in place a strong and senior management team. We are ensuring a range of expertise across the team that includes community services, joint commissioning and estates. This will enable us to quality assure the support we receive and work with our suppliers to ensure it meets our needs.

We are appointing a director who will coordinate the commissioning support we deliver in-house with that which we receive from elsewhere. We are also working with the CCGs around us to agree which commissioning support services we want to share locally.

We are working with PCT cluster and strategic health authority colleagues to understand the best scale for each element of commissioning support. We are working with functional areas within the support unit to agree how they will change the way they deliver services to support clinical leadership.

Clinicians bring the real added value to the commissioning process, but they will only be able to if CCGs have the appropriate infrastructure to both support clinical leadership and provide the expertise to harness its potential. If we don’t act now, and simply take the estate agent’s word for it, we could end up with a house on the edge of an eroding cliff.