Chart: CCG leaders' contracting and integration plans

Respondents were asked which of a list of approaches their CCG is likely to adopt over the next year to 18 months.

A majority of CCG leaders said they were expecting to implement “accountable care systems”. An ACS is generally understood to involve creating new joint governance across both commissioners and providers; but no new provider organisations or joint ventures. HSJ reporterd on plans for an ACS in Berkshire last month.

There was also a majority – 55 per cent – saying their CCG was likely to adopt an alliance contract, under which a commissioner contracts with an alliance of multiple providers. The providers collectively share risk, gain and responsibility for delivery.

Fewer leaders – albeit still 26 per cent – thought it was likely they would establish an “accountable care organisation”. An ACO is generally understood to involve multiple providers working together and taking on joint accountability for care of a specified population, with targets for improving quality and containing costs. NHS leaders in Northumberland, who last year announced they intended to create an ACO, said it would be established as a joint venture created by Northumbria Healthcare Foundation Trust, and involve the CCG having substantially reduced responsibilities.

The full results from this question were:

• David Williams, HSJ’s integration expert, has discussed the attractions of accountable care systems in his weekly briefing, What’s New In Care Models.