The NHS Commissioning Board will need external support, likely to come from management consultancies, to help authorise clinical commissioning groups.
A paper to be considered at the organisation’s board meeting next week says: “Over the next twelve months the CCG authorisation process will require substantial and skilled resource for relatively short periods of time.
“It will be important to ensure that the necessary resource can be secured from the NHS during the transition with appropriate external support where necessary. The full range of development support, both from the NHS and external providers, needs to be sourced.”
The most likely candidates for supporting the process will be management consultancies and potentially accountancy firms familiar with the NHS.
There are currently around 270 emerging CCGs. Although CCGs will not take over full responsibilities until April 2013, the board has said it will make decisions on all their applications between July 2012 and January 2013. It will be supported by a “pre-authorisation” preparation process by strategic health authorities which will begin earlier.
The paper says the process will have to be carried out at a “scale and pace that assumes all CCGs are ready and willing to apply in the timescales to go live in April 2013”.
The board paper identifies availability of the required resource as the main risk to the process. It says: “A detailed and costed programme to undertake the necessary analysis, panel site visits and collation of the evidence for consideration by the board has been completed.
“It is envisaged that given the scale and intense nature of the authorisation process, some external support will be required in relation to analysis and leadership assessment to avoid destabilising the present system’s responsibilities for delivery.” The DH has not yet confirmed the expected cost of the programme.
The board meeting will also be asked to approve some key documents on the new commissioning system - on authorisation, CCG governance, and commissioning support.
HSJ revealed drafts of all three documents last year, but board papers identify some changes.
On the document on commissioning support services - an area which was particularly criticised by the British Medical Association - officials have, “reframed the language to be clearer that this is not about commercialisation, with the caveat that NHS CSSs still need to be competitive and the end-point is still for them to move to freestanding status before 2016”.
They have also, “reaffirmed that CCGs will be able to choose their local NHS CSS up to and beyond April 2013, but that during the transition, these decisions will need to be made carefully and sensitively between CCGs, SHAs and PCT clusters so that HR… can be managed appropriately”.