FINANCE: A clinical commissioning group may redesignate the cost of clinicians’ involvement in service redesign as a ‘programme’ cost to help retain capacity while staying within its running allowance.

All CCGs are given annual allowances for running costs separately from their programme allocations, which are intended to fund health and care services.

The proposal by South Devon and Torbay CCG would involve funding an annual cost of around £300,000 for clinicians sitting on “pathway groups” and leading individual service design work from its programme budget.

Currently, this is funded from its running cost allowance. The sum represents around 4.5 per cent of the group’s £6.8m running cost allowance for 2014-15, HSJ understands. The CCG also said in a board paper that it was working to lobby the government to “relax” its approach to groups’ running costs.

It comes as all CCG running cost allowances are to be reduced further following several years of cuts in spending on running NHS commissioning organisations. Their allowances will be reduced by 10 per cent in 2015-16 compared to 2014-15, in line with the government’s requirement that the Department of Health administration budget be cut by 10 per cent.

A paper presented to South Devon and Torbay’s governing body last month said: “We are progressing plans to investigate the redesignation of clinical leadership costs from ‘running’ to ‘programme’, [and] lobby national leaders to relax the rules on running cost reductions.”

Louise Hardy

The CCG is considering a greater primary care role, Louise Hardy said

The group’s director of organisation development, Louise Hardy, told HSJ: “We are a very lean CCG in terms of staff numbers so we don’t have slack in the system. Because of this, we’re just starting work to look at a range of measures that, taken together, could help us achieve the 10 per cent reduction without damaging the capacity of our workforce.”

Ms Hardy said the CCG was considering taking on greater roles in primary care and specialised commissioning from NHS England, something the national body is expected to want CCGs to do, “but we would not be able to take on these important extra roles without any budget for staff to do the work”.

She said: “Through NHS Clinical Commissioners… we want to make sure that the rules on reducing running costs can accommodate any additional commissioning responsibilities that we take on from NHS England.”

An NHS England spokesman said: “CCGs’ auditors will expect them to follow current standard accounting rules, and any changes to the approach to CCG running costs would need to be agreed by the [Department of Health].”