Simon Stevens has been reviewing the split between NHS England and clinical commissioning group budgets in his first few weeks in his post, and said it will shift.
The new NHS England chief executive said he thought CCGs will thrive when they are given responsibility for primary care services. He would outline how the split between local NHS commissioning would “evolve” on Thursday, MPs heard.
Mr Stevens also said he was “a bit surprised” about the level of “positivity” he had found in the NHS about CCGs’ impact so far.
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He said: “There is an opportunity – not across the board – but there is potentially an opportunity for CCGs to drive change.
“I don’t think we’ve got that completely right just yet, so CCGs will probably do well when they can have responsibility for more of the primary care services in their area.
“We need to make changes for how specialised services are done as well, so we have that population focus, rather than the three-way split in the local resourcing between the primary care services, the local hospital services and the specialist hospital services.
“Part of what I’m doing now in my first few weeks is looking at how we can evolve the system a bit to get some of that in place.”
Later in the session, he suggested that giving CCGs greater oversight of primary care could help avert a crisis in the primary care workforce.
He suggested that the number of GPs has increased much more slowly than the number of hospital consultants since 2000.
“There’s an interesting question about whether we’ve got the balance out of kilter there and if we have, what are we going to do about it,” he told MPs.
“One of the answers I think is to enable CCGs to have more impact over the decisions that are made about spending in primary care services – not just GP services – but primary care services.
“I will indeed be setting out an answer to that at least in outline terms on Thursday of this week.”
Mr Stevens argued that although GPs have been one of the strong points in the NHS, “one of the prices we sometimes paid is that there has been too big a gap between what GPs do and what hospital doctors do”.
He added: “Could you imagine a circumstance in which some of those medical specialties were working more closely with GPs in new types of primary care configuration? Yes you could.
“There are lots of things we should be talking about like that.”
Stevens sets out alternative approach to small hospitals
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Stevens signals shift in 'three-way split' in local NHS commissioning