STRUCTURE: NHS England has prompted a review into the governance arrangements of three clinical commissioning groups following concerns around accident and emergency performance within the local health economy.

Portsmouth, Fareham and Gosport, and South Eastern Hampshire CCGs have agreed to the review following discussions with NHS England Wessex area team, according to a paper presented to Portsmouth CCG’s governing board.

The review will examine the way commissioners work with NHS England and the NHS Trust Development Authority, and identify whether there is “sufficient capacity” to fund any agreed governance arrangements.

The papers said: “This review will focus in particular as to how the CCGs operate collectively and individually to hold the wider system to account, whether this works in practice and whether the individual CCGs are clear about these accountabilities.

“In addition it will look at the interfaces with NHS England and the TDA, as well as whether there is sufficient capacity to resource agreed governance arrangements.”

The three CCGs are in the process of appointing a non-NHS body to conduct the external review, according to a spokesman for the CCGs.

Innes Richens, chief operating officer of Portsmouth CCG, said: “Given the challenges related to the emergency department four hour performance targets in the Portsmouth and south east Hampshire system, the three CCGs and NHS England have agreed that it would be timely to review these governance arrangements to ensure that they are as effective as possible.

“We anticipate that the process will be completed and conclusions received by us by early in the new year.”

A spokeswoman for the area team said: “As part of our wider conversations with the three CCGs around their role in supporting the local trust to deliver the NHS Constitution urgent care standards, we agreed that a review of their governance and working structures arrangements would be timely and beneficial.

“The review will look at the structures and how they work in practice to ensure that the most effective arrangements are in place.”

A draft set of terms of reference have been agreed for the review between the area team and the CCGs.