The leaders of six clinical commissioning groups have written to NHS England criticising “apparent confusion and lack of clarity” in its proposals for primary care co-commissioning, HSJ can reveal.
The letter from six of the seven CCGs in Sussex says the situation means none of them will apply to share responsibility for primary care from April next year, as NHS England has encouraged.
The groups say they are “unable to recommend to the members of our organisations any change to the current commissioning model”.
Shortly after joining NHS England in May, chief executive Simon Stevens announced that he planned to invite CCGs to take on additional responsibility for primary care, from the national organisation. NHS England has told CCGs to submit applications for co-commissioning in January.
In their letter, sent late last week, the groups say there is a “strong undercurrent” for becoming co-commissioners in their areas, but that they cannot “because there is an absence of vital information to give appropriate assurances to our memberships in these very short timescales”.
‘Financial and legal facets of the proposed new commissioning models must be clearly described by the current commissioner, before any transfer of responsibility can occur’
The letter, addressed to NHS England’s Surrey and Sussex area team and seen by HSJ, is signed by 11 chairs and accountable officers of the CCGs.
The groups are Horsham and Mid Sussex CCG, Crawley CCG, Brighton and Hove CCG, Coastal West Sussex CCG, Eastbourne Seaford and Hailsham CCG, Hastings and Rother CCG.
The signatories say they are “cognisant of the impact of any such policy decisions [about co-commissioning] on our local populations, and the potential implications on service delivery”.
“In particular the workforce, financial and legal facets of the proposed new commissioning models must be clearly described by the current commissioner, before any transfer of responsibility can occur,” the letter says.
The CCGs have a “continued ambition to work towards delegated co-commissioning”, but require a more “realistic timescale” and “proper supporting information”, they say.
They suggest that, if “an appropriate level of detail is [made] available” by the national commissioning organisation in January or February, the CCGs may be able to begin co-commissioning in July.
CCGs were initially invited to submit submissions of interest for co-commissioning primary care in May. NHS England last month issued refreshed guidance and asked them to resubmit plans by January, to take effect in 2015-16.
CCGs were invited to choose between having greater involvement in co-commissioning, working in joint committees with area team, or having full delegated authority.
Amanda Doyle, co-chair of NHS England’s primary care co-commissioning programme oversight group, said the body “has set out all the information it can on the legal, workforce and financial issues”.
Dr Doyle, who is also co-chair of NHS Clinical Commissioners, added: “The clear feedback is that most CCGs have found the guidance and the five regional roadshows helpful.
“However this positive view has clearly not been the experience of these specific CCGs and so NHS Clinical Commissioners are available to advise and support the CCGs and NHS England is making the offer of additional immediate conversations with the CCGs but only should they so wish.
“It is of course entirely up to all CCGs to decide whether or not to take advantage of the option of co-commissioning.”
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