Groups to commission for 'their whole population'

The command paper – published today in response to the NHS Future Forum’s report last week – laid out some of the rules commissioners will have to follow in order to receive authorisation.

Local government and public health groups had warned that the new commissioning landscape could leave gaps in provision and hamper integration with social care.

But the paper said the government will be explicit in the bill and in regulations that CCGs will be responsible for “their whole population, not just registered patients”. This means “arranging emergency and urgent care services within their boundaries, and for commissioning services for any unregistered patients”, it said.

CCGs will also have to give a “clear rationale in terms of benefits for patients” if they want to cross local authority boundaries. Groups crossing boundaries will have to give an account of how they expect to “achieve better integration” with social care.

The paper clarified that the NHS commissioning board must agree proposed boundaries as part of a group’s establishment and health and wellbeing boards – housed in local authorities – will be able to object. “The NHS Commissioning Board will always have to satisfy itself that any such objections have been taken properly into account”, it said.

The paper also made clear that commissioners will be able to seek external commissioning support. It said although clinical commissioning groups are not able to delegate their “statutory responsibility” for commissioning to private companies, “This does not in any way preclude NHS commissioners from using external agencies to provide commissioning support, but ensures that statutory responsibility for decisions continues to rest with the responsible NHS commissioner.”