• Cutting commissioning sector would mean more frontline cash says Andrew Morris
  • The former Frimley Health Foundation Trust chief says there is a “push” to do this at the moment
  • King’s Fund chief says the answer will vary across the NHS

Each integrated care system should have just one clinical commissioning group, according to one of the NHS’s most influential figures.

Sir Andrew Morris, who retired from running Frimley Health Foundation Trust in February after 29 years in charge, said: “There is a push at the moment for one CCG to do the commissioning per ICS. I think that’s the logical way forward.”

Since leaving the trust Sir Andrew has led the Frimley Health and Care Integrated Care System, which is covered by several fairly small CCGs.

He told the King’s Fund annual conference in London there needed to be a major “rationalisation” of commissioners, so more money could go into the frontline.

He said: “I believe an [integrated care system] plan should be prime. The thing all organisaitons buy into. Trusts and CCG plans should be secondary.

“You are then into the issue of what does a CCG do? As commissioning shrinks in terms of importance it does challenge one of the key things historically CCGs have done. And as you develop networks and grow them over time you potentially end up with fewer CCGs.”

He added that there were simply “too many organisations in the NHS”.

It comes as NHS England on Friday said it would reduce CCGs’ administration allowance by a fifth by April 2020, and encouraged them to merge or work more together.

King’s Fund chief executive Sir Chris Ham said the question about the role of the CCGs was “the right question but the answer will vary depending on where you are. When I go to greater Manchester people are not talking about one CCG for the whole of Greater Manchester.”

Sir Chris also challenged NHS organisations to transform themselves in the same way some leading local authorities are doing. He said Wigan Council had improved health outcomes while cutting nearly £150m from its budget.

He said: “[It’s done this by] fundamentally changing its relationship with people and communities. Why isn’t the NHS doing more of what Wigan council is doing and being truly transformational in how the NHS relates to patients, people and communities?”

NHS England’s national director of transforming health systems Michael Macdonnell was also on the panel but he would not be drawn on how many CCGs would be needed. He said the skills commissioners have long used in making tough choices on spending finite resources would still be required under new structures like ICSs.