The Health Act 2012 is set to be changed to make it easier for clinical commissioning groups to come together with each other – and with NHS England – to jointly commission services, HSJ has learned.
The move is intended to help and encourage commissioners to propose reconfigurations across large areas, and potentially enable single contracts combining core general practice with other primary and community services.
The Department of Health is proposing to change the act to allow CCGs to delegate decisions to joint committees featuring two or more of them, or with NHS England.
It would make it easier to make decisions spanning specialised and primary services – which are the responsibility of NHS England – and community and general hospital care, which is funded by CCGs.
A DH letter on the proposals sent to CCG leaders says since April it has been “difficult to design services that cut across both CCG and NHS England commissioned service because it not possible to form a binding joint decision making body”. The letter was sent last month and a consultation will run until 7 January.
It comes against a background of concern in the service that the structures and rules which came into force in April are making it difficult to significantly reshape services, which is considered necessary to respond to growing demand with limited funding.
The DH is proposing to use a legislative reform order, a mechanism which can change the law without a new bill, to “reduce burdens” resulting from legislation.
Joint governance of NHS England primary care budgets and CCG budgets may in part address current concerns about primary care commissioning. NHS Clinical Commissioners yesterday called for greater control to be handed to CCGs.
NHS England national commissioning director Ros Roughton, speaking to HSJ this week in response to the NHSCC survey, said the DH’s proposals could help improve the situation.
Commissioners would be able to consider how to use their budgets together to get the “best outcomes for the population”, she said.
Ms Roughton also indicated NHS England would next month publish details making it clearer CCGs can invest in primary care services, including from GP practices, as long as they are over and above “core” GP contract requirements.
She said the national body would also “be a bit clearer about the expectation that CCGs and NHS England at area level [will] have a shared strategy for improvement in primary care”.
She said, “given CCGs are led by clinicians and particularly GPs it makes a lot of sense” for them to be more involved in primary care commissioning.
However, Ms Roughton said the national commissioning body’s responsibility for core GP services – which is set out in the Health Act – would not change.