CCG Barometer: Leaders call for merger 'ban' to be lifted

Forty-six leaders took part in the latest HSJ CCG Barometer, in association with Capsticks. Fifty-nine per cent said they believed NHS England should lift its informal ban on CCG mergers. However, more than half said mergers were unlikely to take place by 2017.

Respondents were given possible options for how CCG responsibilities might shift by April 2017 and asked to rate how likely these were. Nearly 60 per cent said it was likely or very likely that they would transfer a substantial amount of their responsibilities to a provider or groups of providers.

Forty-five per cent of respondents said “sharing responsibilities and budgets with local government under devolution arrangements” was likely or very likely, while 59 per cent said sharing budgets and responsibilities across groups of CCGs would take place.

Merging with another CCG was unlikely to happen by April 2017, 53 per cent said, which may reflect the current approach to them.

So far only Gateshead, Newcastle North and East and Newcastle West CCGs have merged.

NHS England has not formally banned CCG mergers, but chief executive Simon Stevens has indicated he does not want any more to take place.

Commissioners were also asked what responsibilities they envisaged having by 2017, with 91 per cent of those that answered saying they would be responsible for general practice in addition to their original responsibilities. Responsibility over some specialised services was also widely expected, and responsibility over more public health services was expected by 41 per cent.

Only 7 per cent said their CCG would no longer exist by 2017. 

The barometer also reflected a positive attitude towards GP engagement and involvement by CCGs. Fifty-seven per cent said GP engagement and involvement in their CCG had increased since April 2013 and 43 per cent believed it would increase by 2017.

Peter Melton, chief clinical officer at North East Lincolnshire CCG, said: “I welcome NHS England’s approach to be permissive in letting CCGs and local commissioners work out their own arrangements, and where merging that makes sense then I think as part of that permissive approach it would be helpful for NHS England to allow them to do that.

“I think a lot of CCGs are looking in to how they collaborate at scale and feel that actually they could do that without full CCG merger. Actually, some CCGs are slightly concerned that if you start to go down the merger route that could be a distraction and take a lot of time and energy when actually what they are trying to achieve could be done through collaboration as opposed to full merger.”

Steve Kell, co-chair of NHS Clinical Commissioners and chair of Bassetlaw CCG said: ”We need the full commitment of national government and NHS England to an approach that allows all parts of the NHS to work together to find the local solutions that work for them for the benefit of their patients and local populations.”

NHS England was approached for comment.