Twenty-six CCGs have been rated inadequate by NHS England as part of a new annual ratings system.

A further 91 have been rated requires improvement, 82 good and 10 outstanding based on their 2015-16 performance. The “headline assessment” was based on five elements: leadership, planning, finance, performance and delegated functions.

Last year, health secretary Jeremy Hunt announced CCGs would be receiving “Ofsted style” ratings.

HSJ understands the initial process for deciding ratings resulted in around three-quarters being given inadequate ratings and none were outstanding. However, a few weeks ago, NHS England officials decided to the decision process was flawed and ordered widespread re-rating.

NHS England said on Thursday it is introducing a “new approach” to CCG ratings from 2016-17. Groups will be rated in 29 areas, including cancer, dementia, diabetes, learning disabilities, maternity and mental health. Ratings will be underpinned by 60 indicators.

The national body will be “taking action” against the 26 rated inadequate. CCGs rated inadequate will be required to develop and implement a performance improvement plan under legal directions from NHS England.

The 26 CCGs rated inadequate are:

  • Bedfordshire CCG
  • Brighton and Hove CCG
  • Cambridgeshire and Peterborough CCG
  • Coventry and Rugby CCG
  • Cumbria CCG
  • East Surrey CCG
  • Enfield CCG
  • Havering CCG
  • Herefordshire CCG
  • Kernow CCG
  • Medway CCG
  • Northern, Eastern and Western Devon CCG
  • North Hampshire CCG
  • North Somerset CCG
  • North Tyneside CCG
  • Northumberland CCG
  • Shropshire CCG
  • South Cheshire CCG
  • South Devon and Torbay CCG
  • South Gloucestershire CCG
  • Southport And Formby CCG
  • St Helens CCG
  • Surrey Downs CCG
  • Vale Of York CCG
  • Walsall CCG
  • West Cheshire CCG

The then CCGs rated “outstanding are:

  • Bassetlaw CCG
  • Dudley CCG
  • East Lancashire CCG
  • Fylde and Wyre CCG
  • Harrogate And Rural District CCG
  • Hartlepool And Stockton-on-Tees CCG
  • Newcastle Gateshead CCG
  • Salford CCG
  • Sandwell and West Birmingham CCG
  • Wolverhampton CCG

NHS Clinical Commissioners chief executive, Julie Wood said: “Both commissioners and providers alike are facing multiple challenges, including increasing demand for services and additional expectations being placed on them by the centre to deliver more at pace – this has had a direct knock-on effect for CCGs finances where, for the first time many more CCGs are struggling to balance the books.

“The decline in CCG finances is something we have previously given warnings on, with the allocative growth in the 2016-17 funding cycle having already being committed to existing or announced projects or funding streams.

“The simple truth is there is no spare money in the system – we urgently need a cross-governmental review into the overall financial position of the NHS and an open debate about what can be realistically delivered with the current level of funding.”

Simon Stevens, chief executive of NHS England, said: “Precisely because the pressures across the NHS are real and growing, we need to use this year both to stabilise finances and kick-start the wider changes everyone can see are needed. Most trusts and CCGs know what needs to get done to release funds for local reinvestment in better patient care and now is clearly the time to fire the starting gun.”