NHS England has temporarily suspended its rule requiring a clinical commissioning group to have clinician in one of its top two roles, in the case of a struggling Midlands CCG, it has emerged. 

  • NHS England temporarily suspends guidance requiring CCGs to have a clinician in at least one of its accountable officer or chair roles
  • Financially trouble Bedforshire CCG plans to fill one of the posts with a clinician in the near future

Bedfordshire CCG, which has been subject to NHS England intervention and legal direction since May, after serious financial problems were discovered, does not have a clinician in either position.

The CCG’s previous accountable officer Paul Hassan, a GP, resigned in March.

Bedfordshire CCG appointed Nick Robinson, whose background is accountancy, as interim accountable officer in March. NHS England said the CCG’s non-clinical chair, Steve Hone, was kept in his role at the time to ensure business continuity.

Guidance published by NHS England in July 2012 states: “All CCGs will need to identify their senior clinical voice for interactions with stakeholders and especially the NHS Commissioning Board [now NHS England]. The clinical leader will either be the chair of the governing body or undertaking the accountable officer role.”

NHS England told HSJ the guidance was not followed in this instance due to Bedfordshire CCG’s exceptional circumstances, which required the appointment of an interim accountable officer with experience in turning troubled organisations around.

The agency added that the guidelines outlining “roles, attributes and skills” for CCG governing body members were non-statutory, and pointed out that the CCG had two interim deputy chairs who were clinicians.

A recruitment process for a substantive accountable officer is currently underway.

An NHS England spokeswoman said: “Bedfordshire CCG have been experiencing financial difficulties since the start of the financial year. This required the appointment of an experienced interim accountable officer who specialises in turnaround.

“The CCG retained their non-clinical chair to ensure business continuity and corporate knowledge and to support the CCG turnaround.

“As a result of this change both the interim accountable officer and chair are non-clinical.

“To offset this, the CCG has two interim assistant clinical deputy chairs, ensuring there is clinical guidance and experience during this period. 

“When we appoint a substantive accountable officer, we will seek a clinical chair should the newly appoint accountable officer be non-clinical.

“The role outlines, attributes and skills for CCG governing body members set out by NHS England are intended for guidance, and are non-statutory.”

Analysis HSJ carried out earlier this year of CCG board membership showed that, according to 2014-15 annual reports, fewer than a fifth of groups have more GPs on their governing body than non-GPs. Conversely, more than four-fifths had a non-GP majority. The average proportion of GPs on CCG governing bodies, according to the analysis, was 41 per cent.