The NHS Commissioning Board has announced it is rethinking the structure of its local offices to avoid “crowding out” clinical commissioning groups.
There will be fewer than the 50 previously mooted.
A letter sent to primary care trust leaders last week said the board’s thinking on its newly christened “local area teams” had changed, as there will be fewer CCGs than had earlier been expected.
The final configuration of local area teams will be decided at the board’s next meeting, on 31 May. It will not reflect the current configuration of 50 PCT clusters, as had been previously thought.
Commissioning board chief operating officer Ian Dalton said the rethink was mainly due to changes to the development of CCGs, which have fallen in number over the past three months. Leading figures anticipate a final tally of about 220 CCGs.
In his letter, Mr Dalton said he “will want to be convinced that the number [of local teams] is neither too high to enable strong relations to be built between senior leaders nor so low as to create any sense that the board is ‘crowding out’ the legitimate role of the CCG”.
The letter said: “Current thinking is that each local area team should relate to a minimum of three CCGs.” Some PCT clusters contain fewer than three CCGs.
Although Mr Dalton declined to give a total number HSJ understands there will be fewer than 50.
Some of the board’s local area teams will carry out specialist commissioning and commission public health services on behalf of others, the letter says.
Although latest commissioning board guidance shows its annual running cost could be £111.7m more than the previous estimate of £492m, Mr Dalton would not be drawn on whether this would mean a proportionate increase in staffing numbers.
It is currently expected that 2,500 people will work in commissioning board local area teams.
Mr Dalton told HSJ that recruitment of local directors would “rapidly” follow the decision on the number of local area teams. He said: “We’re going to need people with high degrees of judgement, significant managerial experience and an ability to flex their leadership style.
“The jobs require very high calibre people. I’m expecting that when we’re able to be clear about the boundaries [covered by local area teams] that those jobs will be very attractive for people currently in senior positions in the NHS.”
One strong candidate to be an area team director said making the patches larger and giving additional responsibilities to the offices would make them more attractive. He said: “Ian Dalton has a selling job. Most PCT cluster chiefs who have been doing their jobs 10 years don’t like the idea of being directly line managed, possibly by a regional director who has never been a PCT chief executive.”
He said: “We’re reorganising the reorganisation constantly. Each time creates another round of uncertainty… now it is up in the air again.”