NHS England’s director of commissioning support strategy has indicated he is “deeply sceptical” that clinical commissioning groups can function at their best without buying in support services.
Bob Ricketts also said NHS England planned to ensure CCGs would not “devastate” the support market by hosting commissioning functions internally, rather than buying them from support units.
He was speaking at the Commissioning Show event in London last week.
Mr Ricketts said CCGs should consider whether their initial commissioning support arrangements were right “over the next three or four months”.
He said both CCGs and support units themselves needed to work with others to support them to transform services.
Mr Ricketts said: “I think I would be deeply sceptical of the ability of any CCG on its own, or any commissioning support unit, without partnering to be able to deliver the really good support on [service] transformation.”
In relation to CCG in-house support, he added: “At the very least there’s a responsibility to work through that process and do it in an informed way [so] that you’re aware of what the options out there are.”
“There needs to be some challenge,” he continued. This could be in the form of auditors assessing whether CCGs’ support services represented good value, he said.
Last week HSJ revealed there is a hundredfold variation in the size of CCGs’ workforces. The main reasons are variation in their populations size, the extent to which they outsource to CSUs, and how much they share support services with other CCGs.
Mr Ricketts said: “It wouldn’t be acceptable for a CCG to say it’s going to do [everything] in house, and then you find lo and behold it’s not doing transformation.”
He also revealed NHS England would hold private discussions with CCGs in the summer about the need for them to be aware of the effect their decisions on commissioning support could have on the wider system.
“If a CCG decides it wants to put it all in house, and the effect of that is to devastate [provision] for its neighbours, I think there’s a system interest in terms of managing risk… CCGs need to behave responsibly.”
A strategy for developing commissioning support, published last week, revealed NHS England would assess the effectiveness of CCGs’ approach to outsourcing support, and how far they have “the right balance” of in-house and external services.