CCG management could learn from schools - Lansley

Andrew Lansley was pressed at the NHS Alliance conference yesterday (Wednesday) on emerging CCGs which are being pressed to merge to become larger, so they can operate under the running cost cap.

Alliance and NAPC analysis says the expected £25 per head administration allowance means groups must serve a population of at least 100,000. Some CCGs of 250,000 or 300,000 are reporting being told they are too small.

But Mr Lansley told the conference: “They [CCGs] do bear comparison to a governing body of a school.

“For a CCG of 100,000 we are talking about £2.5m [for] running costs. The [commissioning budget] could be £150m.

“Most schools are doing it on the basis of 1,500 children and a budget of less than a couple of hundred thousand [pounds] for administration.”

He said: “Our experience is only the past experience of the NHS where big is always better. If you look outside the NHS it is perfectly possible to do it [run small statutory organisations].

“Maybe a bit of looking outside the NHS is not a bad idea. They [schools] mange to meet their statutory accountabilities on a small budget.”

However Mr Lansley did acknowledge some CCGs may need to either share many functions, or merge to create a larger CCG which can in turn delegate responsibility to smaller localities.

He said: “It will be difficult for very small CCGs to try to manage all their responsibilities without working with others.”

Speaking at the conference earlier in the day, NHS chief executive Sir David Nicholson stressed decisions about size and shape of CCGs should be a “bottom up” decision.

He said about 10 per cent of CCGs were currently rated as “red” for their shape and size against the DH risk assessment tool. But he said: “That is a risk rating, it is not a pass or fail.”

Sir David also said he would look at whether CCGs could be given choice of whether their support was provided by alternative primary care trust clusters before April 2013, something the NHS Alliance has requested.