Providers could face financial difficulties if commissioning consortia decide to topslice their budgets to create risk pools, the Commons health committee has heard.
Audit Commission managing director for health Andy McKeon said the NHS Commissioning Board’s authorisation process would need to ensure steps taken to guard against the risk of overspending by consortia did not destabilise providers.
Giving evidence to MPs on Tuesday, Mr McKeon said: “The proven method of doing that [managing the risk of overspending] within the NHS would be to have some sort of topslicing in order to create a risk pool across consortia”.
But he added: “If all bits of the commissioning side of the NHS decide to keep back an amount to ensure against their own risks that will place the hospital side in difficulty.”
Mr McKeon said the NHS Commissioning Board would have to judge what were “prudent” risk pooling arrangements.
He said the board’s authorisation process for consortia should test financial planning and awareness, the ability to monitor information for commissioning purposes and “clinical engagement within the consortium”.
He also said it was “uncertain” whether all consortia would be “ready and able” to take over commissioning responsibilities in 2013.
He said: “Not everybody will get through [the authorisation process].”
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