A GP will be appointed as the deputy medical director of the NHS Commissioning Board, its medical director Sir Bruce Keogh has said.

The appointment – unlikely to be made before the spring – will to some extent answer concerns about a lack of national primary care representation.

Sir Bruce told HSJ: “In my view the commissioning board is there to support clinical commissioning groups in commissioning the best possible services they can.

“That needs someone in a senior position in the commissioning board who really gets primary care and commissioning.”

The board will directly commission primary care and some specialist services, and be responsible for holding CCGs to account, from April 2013. This will include issuing clinical guidance.

Sir Bruce said the commissioning board would act as a clinical advice “hub”, avoiding duplication between central bodies. He said: “The centre of gravity of clinical advice nationally will be the commissioning board. It will develop a relationship with the other arms length bodies, and the Department of Health, to provide them with clinical advice.”

Currently most senior clinicians nationally, including the national clinical directors, are based in the DH.

Sir Bruce said the commissioning board would include himself, a deputy from primary care, the chief professional officers, senior “clinical managers” for each of the five domains of the NHS Outcomes Framework, and national clinical directors.

Several national clinical directors, speaking anonymously in recent weeks, have told HSJ they were concerned about the future of national clinical leadership. Sir Roger Boyle – who covered heart disease and stroke – quit in the summer, and made a powerful attack on the government’s NHS reforms. The contracts of many of the other national clinical directors end in March 2012.

As well as their own positions, they are concerned about the uncertainty for clinical networks, which are currently being reviewed; and whether national clinical improvement programmes will be possible, or successful, in the reformed commissioning system.

Sir Bruce said there would be national clinical directors in the commissioning board and they needed to cover a “broader spectrum of clinical areas” than at present. However, it could involve changing the current roles, and may not mean more individual national clinical directors.

He said: “I am keen to have national clinical directors on the commissioning board because I want it to have major clinical leadership. The NCDs brand has a lot of credibility but there are some areas that historically have not been represented.”

Sir Bruce said he was hoping to make decisions in the New Year, but the commissioning board may not be formally established until October, so it was not possible to set dates.

He said – as well as national roles – he wanted “to get clinical advice [for the board] from people deeper in the service”. He added: “There is an opportunity to do that through networks, senates and CCGs.”

Sir Bruce, a professor of cardiac surgery and former president of the Society for Cardiothoracic Surgery, was this month confirmed as the board’s designate medical director.

Topics