• Six CCGs conditionally approved to merge into two larger groups
  • CCGs in Derbyshire and Devon have had major financial problems
  • Comes as NHS England encourages more CCGs to merge

A new batch of clinical commissioning group mergers - involving six groups - have been conditionally approved by NHS England.

It comes as the national body turns up the pressure on CCGs to join forces, reducing their management costs by a fifth over the next 16 months.

Two sets of mergers – involving CCGs in Derbyshire and Devon – have been approved subject to specified conditions being met. Both the areas have faced substantial financial or performance problems.

If the mergers go ahead it will mean Derbyshire and Devon sustainability and transformation partnerships would have one CCG each.

The four Derbyshire CCGs planning to merge – North Derbyshire, South Derbyshire, Erewash and Hardwick – all have the same accountable officer, Chris Clayton. North Derbyshire CCG is currently subject to NHS England legal directions because of financial problems. It overspent by £24.1m (5.4 per cent of budget) in 2017-18, while Southern Derbyshire overspent by £18.1m (2.4 per cent). April 2019 has been given as the planned date for this merger.

The Devon CCGs which are due to merge – Northern, Eastern and Western Devon and South Devon and Torbay – also share an AO, Simon Tapley. No date has been given for this merger. NEW Devon has a very large cumulative deficit, having faced financial problems over several years.

If these mergers go ahead, there will be 191 CCGs, down from 211 when they were created in 2013.

In a letter to CCGs this month, NHS England said it would “particularly support” mergers which create “a single CCG area with a single integrated care system”. The letter also said areas should be ”exploring mergers and joint ways of working” as a way to make mandated 20 per cent administrative budget cuts, and that it would now consider merger applications through the year rather than only on an annual basis.

In April this year, 18 CCGs merged into six larger groups - before this there had been mergers in only two places.

The Derbyshire CCGs said in a statement that NHS England’s conditions for the merger to go ahead include appointment on an appropriate chair, AO and chief finance officer - in particular the CFO, given North Derbyshire’s legal directions. NHS England must also approve ”a robust financial recovery plan that sets out how the new organisation will repay its existing cumulative deficits and achieve underlying financial sustainability”. 

Dr Clayton said in a statement: “This is an exciting opportunity for us to make strategic commissioning decisions across a single CCG to benefit Derbyshire patients and provide consistency and reduce duplication for ourselves and the hospitals, community and mental health services we contract with.” He said the CCGs were “fully committed to accelerating the implementation of what has become known as ‘place based’ commissioning, where local GP practices and other partner services get much more involved in determining some of the services they believe are required specifically for patients in their own area”.

The Devon CCGs and NHS England were approached for comment.