Clinical commissioning groups will be rated each quarter on their effectiveness across six domains under an NHS England assurance framework to be published today.

The CCG assurance framework guidance (see attachment), along with a similar framework for assessing NHS England’s own local area teams, has been developed over the past six months.

NHS England – working through its area teams – will now begin assessing CCGs using it. They will be rated against each of six “domains”, similar to those used in the CCG authorisation process, and an overall rating.

The possible ratings are “assured”, “assured with support” and “not assured, intervention required”. The guidance says the final category will be used in “rare circumstances”.

The process will include examining CCG performance, capability, various forms of evidence, and discussion with the group. There will be assessments at the end of the first, second and third quarters of the financial year, and a summary assessment at the end of the year.

Judgements “will be based on the level of risk associated with the CCG’s current plans and progress, and wherever possible, will be a joint decision made with the CCG,” guidance says.

In future, after at least a year of running the process assurance, NHS England local teams may decide some CCGs no longer need to be tested each quarter.

Once ratings are agreed, NHS England will send the CCG a “summary report” also including “any agreed action plans and improvement trajectories”. The guidance says: “NHS England would expect this [summary report] to be published locally.”

Documents published today say changes have been made to the assurance framework in response to feedback from CCGs. These include removing a list of detailed tests and requirements.

NHS England chief operating officer and deputy chief executive Dame Barbara Hakin said: “This process will be a continuous assessment of CCGs’ and direct commissioners’ capacity and capability to meet statutory and planning requirements, meet the needs of local populations, reduce health inequalities and provide the best possible outcomes for local people in the most cost effective way.

“The assurance frameworks will build on what CCGs and direct commissioners are already doing and are designed to support them to become the best commissioners they can be.”

Assurance domains

Domain 1: Are patients receiving clinically commissioned, high quality services?

Domain 2: Are patients and the public actively engaged and involved?

Domain 3: Are CCG plans delivering better outcomes for patients?

Domain 4: Does the CCG have robust governance arrangements?

Domain 5: Are CCGs working in partnership with others?

Domain 6: Does the CCG have strong and robust leadership?