The Department of Health has set out key details of the authorisation process for clinical commissioning groups – but stopped short of providing a clear list of requirements or a “bar” for approval.

Update - 13 December, 2012 - HSJ publishes interactive commissioning system map

HSJ has launched the first comprehensive interactive map of the reformed NHS commissioning system, showing critical details about the new organisations, including their leaders, performance, budgets and size. View it here

A draft of Developing Clinical commissioning Groups: towards authorisation was revealed on last week. The NHS Commissioning Board will use the process to decide whether CCGs are ready to take on commissioning budgets and whether they need extra support, such as external finance assistance.

The “road map” starts this autumn when CCGs, assisted by strategic health authorities, are expected to carry out a risk assessment of their size and shape. Those judged too risky will be rated “red”.

The document indicates that all practices in a CCG will have to be “contiguous” (neighbouring each other), not widely dispersed, and “reflect the entirety of the geographic population”. It says emerging CCGs should now “gain experience and continue to build up a track record” by taking on delegated responsibilities  from primary care trusts and leading the planning of services.

When the NHS Commissioning Board is established – between July and October next year – CCGs can apply for, and be granted, authorisation to become statutory bodies. By April 2013 CCGs across England will be authorised either in full, to commission only some services, or in “shadow” form – meaning the commissioning board or another CCG would take charge of their functions.

National director for commissioning development Dame Barbara Hakin told HSJ the authorisation process would be a “developmental journey” and the DH would work to ensure “lots and lots of CCGs are authorised without any conditions [restricting what they can do]”.

“Although it’s inevitably going to culminate with a specific process, what will be going on is a lot of development long before the CCG submits its application, and that development will continue [after authorisation],” she said.

Dame Barbara urged CCGs to focus initially on “what they want to achieve for their patients and population, and how they can be really different… [before] spending a long time on form and governance”.

A full authorisation framework will be published early next year. One senior PCT source said last week’s guidance could be seen as “avoiding the question” of “how high the bar is going to be” on CCG authorisation as  this had not yet been agreed.

NHS Alliance chair Michael Dixon praised the guidance’s developmental approach. However, he said PCT clusters, whose successor bodies could retain a larger role if CCGs were not ready, had an “incentive not to move things fast”.