A number of broad themes emerge from the survey, stepping back from the detail. These include clinical commissioning groups’ desire for supportive relationships with the NHS England local area and regional teams, and the fear that politics could play an increasingly central role in shaping the NHS to the detriment of the service.
The detail provides some fascinating snapshots which capture the frustrations of new and emerging organisations trying to forge a role in a changing system. Time will tell whether the complaints and criticisms are cracks in the system or just teething problems. But the need for sound relationships, based on trust and built at a local level, is an interesting output from the survey. It is one which affects who leads CCGs and how they lead.
It is noticeable that only half of respondents believe CCGs will dominate the planning of major service change. Many see NHS England as a major partner in this. Has the system not yet shaken off old top-down habits, or is this the necessary reality check which comes with a service that must act regionally and, occasionally, nationally to function?
A significant number of respondents appear to support some national coordination of the integration of services, yet it is not clear how proposed policies on this will develop. It means requirements such as “being able to cope with high levels of ambiguity” will be appearing in job descriptions for some time yet.
Confidence in the evolving system is growing. While gaps are still apparent – such as how to deal with patient involvement and metrics – it’s encouraging to see this trend. Perhaps if the NHS is allowed to bed these changes in and learn how to run itself, confidence will continue to grow. If it does, and a community of CCG leaders with strong interdependent relationships emerges, then the requirement for handling ambiguity may no longer be quite so sought after.
Robin Staveley is a health practice partner at GatenbySanderson
CCG Barometer: Confident commissioners voice gripes with new system
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CCG Barometer commentary: Confidence despite ambiguity