Clinical commissioning groups will not be awarded extra funding to run primary care co-commissioning, NHS England has confirmed.
In a paper outlining the next steps towards commissioning, NHS England says there is “no possibility of additional administrative resources being deployed on these services at this time due to running cost constraints”.
The paper however hints that this situation could alter in the second year of its co-commissioning scheme. “Whilst it is not within our gift to increase running costs in 2015-16, NHS England will keep this situation under review.”
It adds that the way funds are distributed under co-commissioning arrangements will be a “matter for local dialogue and determination” between CCGs and NHS England area teams.
The document says CCGs taking on delegated commissioning responsibilities would “have access to a fair share of the area team’s primary care commissioning staff resources”.
NHS England’s area teams would however have to “retain a fair share of existing resources to deliver all their on going primary care commissioning responsibilities”.
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CCGs would be given greater flexibility to “top up” their primary care allocation with funds from their main allocation, according to the document.
The paper also confirms that NHS England would retain functions relating to the individual GP performance management under any new commissioning arrangements.
“There has been clear feedback from CCGs that it would not be appropriate for CCGs to take on certain specific pseudo-employer responsibilities,” it says. NHS England would also retain control over list management and administering payments, under its proposals.
The document also expands on plans to free CCGs to allow GP practices to move off the national GP pay for performance framework and create new contract arrangements under the new commissioning arrangements.
CCGs would have the “ability to offer GP practices the opportunity to participate in a locally designed contract”, which would be “above or different from the national requirements”.
While these local schemes would not be subject to a formal approvals process, they would require a consultation with the local medical committee and must be “able to demonstrate improved outcomes, reduced inequalities and value for money”, the document says.