The dozens of clinical commissioning groups which do not meet the government’s size and shape requirements will have to agree “alternatives” in the next few months.
GPs have been encouraged to develop CCGs in all shapes and sizes since the government’s white paper in July last year.
But the Operating Framework 2012-13 published today says the management allowance for CCGs is “expected to be” £25 per unweighted head of population. A DH-supported review this week say that level of funding means an effective minimum population of 100,000 per CCG.
The operating framework also says: “As far as possible CCGs should be coterminous with a single local Health and Wellbeing Board.” That is a change from previous policy and effectively means CCGs should be coterminous with upper tier local authorities.
Many CCGs are not coterminous with councils and 63 of the 257 pathfinder CCGs have a population smaller than 100,000.
CCGs were told to risk rate their size and shape earlier this year and some pathfinders may have already merged. But the operating framework says all will have to finally agree their size and shape earlier next year.
It says: “Specific guidance on the process for authorisation will be issued in due course…
“Ahead of that, SHA clusters should be working to support practices and emerging CCGs to resolve configuration issues. By 31 January 2012, SHA clusters need to be confident that any outstanding configuration issues can be resolved by the end of March 2012.
“Where this is not the case, the timetable for authorisation means that discussions on alternatives will need to take place. SHA clusters will be responsible for oversight of the readiness of CCGs for authorisation.”
The Operating Framework also says:
- It is “expected” clinical networks and senates will be established during 2012-13. The framework says: “Work is ongoing to design the role and function of clinical senates. One of their key roles in 2012-13 will be to contribute to engagement on clinical service redesign across wider health communities.”
- PCT clusters must develop “commercially viable, customer focused” commissioning support “vehicles” which “develop distinctly and separately from the PCT cluster”. The framework says they “may occupy a different geographic and service footprint to that of clusters or their constituent PCTs. Opportunities to aggregate demand from CCGs in aspects of commissioning support should be facilitated by PCT and SHA clusters.”
Full list of pathfinder CCGs with a population of less than 100,000
Arterial Community Interest Group
Geographical area: Basildon & Billericay
Number of practices: 12
Population size: 62,657
Brentwood Clinical Commissioning Group
Geographical area: Brentwood (South West Essex)
Number of practices: 8
Population size: 74,121
Cam Health Integrated Care
Geographical area: Cambridge
Number of practices: 6
Population size: 57,809
Castle Point GP Consortium
Geographical area: Canvey Island & Benfleet
Number of practices: 15
Population size: 85,213
Essex GP Commissioning
Geographical area: Chelmsford
Number of practices: 7
Population size: 69,937
Hunts Health
Geographical area: Huntington
Number of practices: 10
Population size: 73,346
The Multi-consortium Commissioning Group
Geographical area: Thurrock & Basildon
Number of practices: 22
Population size: 67,715
The Red House Group
Geographical area: Hertfordshire
Number of practices: 1
Population size: 18,900
South Essex Managed Care Consortium LLP
Geographical area: Wickford and Basildon
Number of practices: 10
Population size: 51,832
Southend Estuary (Previously Fortis Group)
Geographical area: Leigh-on-sea, Essex
Number of practices: 9
Population size: 75,448
Thorpe Bay Clinical Commissioning Group
Geographical area: Southend
Number of practices: 22
Population size: 71,489
Thurrock Managed Care
Geographical area: Thurrock
Number of practices: 17
Population size: 97,208
Boston
Geographical area: Lincolnshire
Number of practices: 9
Population size: 80,660
Corby
Geographical area: Corby
Number of practices: 7
Population size: 67,124
East Lindsey
Geographical area: Lincolnshire - East Lindsey
Number of practices: 14
Population size: 87,800
High Peak Clinical Commissioning Group
Geographical area: Mixture of rural areas and five major towns across north western tip of Derbyshire
Number of practices: 8
Population size: 59,519
Nottingham West Consortium
Geographical area: Broxtowe locality which encompasses Beeston, Chilwell, Bramcote, Stapleford, Kimberley and Eastwood
Number of practices: 12
Population size: 93,000
Skegness and Coastal
Geographical area: Skegness and Coastal
Number of practices: 7
Population size: 72,000
South Holland
Geographical area: South Holland area of Lincolnshire
Number of practices: 8
Population size: 73,770
Wellcomm
Geographical area: Lincolnshire (market towns of Stamford, Bourne, Market Deeping, Crowland and surrounding areas)
Number of practices: 7
Population size: 80,545
Havering First Consortium
Geographical area: Havering (part of)
Number of practices: 25
Population size: 95,447
KLEAR Healthcare Consortium
Geographical area: City & Hackney (not whole borough)
Number of practices: 9
Population size: 47,438
Newham Commissioning Group (NCG)
Geographical area: Newham (part of)
Number of practices: 11
Population size: 68,199
United Medical Consortium (UMC)
Geographical area: Barking & Dagenham (part of)
Number of practices: 16
Population size: 67,336
Victoria Commissioning Consortium (Westminster)
Geographical area: Westminster
Number of practices: 8
Population size: 48,182
Greater Eston
Geographical area: Redcar and Cleveland LA
Number of practices: 6
Population size: 40,856
North Tyneside Engage
Geographical area: North Tyneside
Number of practices: 11
Population size: 83,000
1-ALPF Health Commissioning Consortium
Geographical area: Ashton Leigh and Wigan
Number of practices: 62
Population size: 90,832
2 - TABA Consortium
Geographical area: Ashton Leigh and Wigan
Population size: 45,127
3- North Wigan Consortium
Geographical area: Ashton Leigh and Wigan
Population size: 54,946
4 - Wigan Commissioning Consortium
Geographical area: Ashton Leigh and Wigan
Population size: 75,998
Bolton Collaborative Cosortium
Geographical area: Bolton
Number of practices: 9
Population size: 29,000
Burnley
Geographical area: Burnley
Number of practices: 17
Population size: 97,147
Fleetwood Community Commissioning Group
Geographical area: Fleetwood
Number of practices: 3
Population size: 25,000
GP CARE Group CIC (Community Interest Company)
Geographical area: Heywood, Middleton, Rochdale
Number of practices: 14
Population size: 78,700
Hyndburn
Geographical area: Hyndburn
Number of practices: 19
Population size: 79,710
Kirkby
Geographical area: Knowsley
Number of practices: 8
Population size: 47,085
Middleton & Heywood Healthcare LLP
Geographical area: Heywood, Middleton, Rochdale
Number of practices: 15
Population size: 80,300
Pendle
Geographical area: NHS East Lancashire
Number of practices: 16
Population size: 89,200
Ribblesdale GP Consortium
Geographical area: East Lancashire
Number of practices: 4
Population size: 36,712
Rochdale West LLP
Geographical area: Heywood, Middleton, Rochdale
Number of practices: 10
Population size: 64,000
Rossendale
Geographical area: East Lancashire
Number of practices: 8
Population size: 67,444
Runcorn Commissioning Consortium
Geographical area: Halton
Number of practices: 8
Population size: 64,947
Widnes Commissioning Consortium
Geographical area: Widnes and St Helens
Number of practices: 10
Population size: 63,000
Wirral NHS Alliance
Geographical area: Wirral (part of)
Number of practices: 6
Population size: 32,000
East Cliff Practice
Geographical area: Ramsgate
Number of practices: 1
Population size: 14,600
East Elmbridge
Geographical area: East Elmbridge
Number of practices: 8
Population size: 56,769
Farnham
Geographical area: Farnham
Number of practices: 5
Population size: 45,864
Golden Valley
Geographical area: South West Surrey
Number of practices: 2
Population size: 29,954
Maidstone and Malling
Geographical area: West Kent
Number of practices: 11
Population size: 98,506
MedLinc
Geographical area: North Surrey
Number of practices: 10
Population size: 79,635
Surrey Heath
Geographical area: West Surrey
Number of practices: 9
Population size: 90,436
Whitstable Practice
Geographical area: Whitstable
Number of practices: 1
Population size: 32,000
Bridgewater Bay Health Federation
Geographical area: Somerset
Number of practices: 11
Population size: 80,000
East Mendip Federation
Geographical area: Somerset
Number of practices: 3
Population size: 50,300
Mid Cornwall Medical PBC Commissioning Group
Geographical area: Cornwall
Number of practices: 6
Population size: 51,108
South Hams & West Devon Commissioning Group
Geographical area: Devon
Number of practices: 14
Population size: 85,000
Birmingham Inner City Consortium
Geographical area: Inner City Birmingham mainly Washwood Heath
Number of practices: 6
Population size: 26,229
Black Country GP Consortium
Geographical area: Rowley Regis, Tipton and Warley
Number of practices: 18
Population size: 91,788
Nuneaton & Bedworth
Geographical area: Nuneaton and Bedworth
Number of practices: 11
Population size: 41,419
Rugby Clinical Commissioning Group
Geographical area: Rugby
Number of practices: 12
Population size: 97,179
South Birmingham Independent Commissioners
Geographical area: Kings Norton, Hopwood, Northfield, Cotteridge, Stirchley, Selly Oak, Selly Park, Bournbrook, Bourneville, Maypole, Broadmedow, Kings Health and Moseley in the main
Number of practices: 9
Population size: 30,000
South Elmsall and Rycroft Consortium
Geographical area: Wakefield
Number of practices: 1
Population size: 20,814
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