NHS England moves CCGs to 'single commissioning structures’

East Surrey CCG will be affected by the change, as will South Gloucestershire and North Somerset CCGs, which have been instructed to work with Bristol CCG to develop a single structure in their sustainability and transformation plan patch.

It is unclear what form these new structures will take. 

HSJ understands NHS England believes it will be able to employ various models for severely troubled CCGs, such as CCG merger, or passing responsibilities to local authorities or accountable providers.

It has said little today about how that can be achieved and is still working on the detail.

However, its announcement that it is introducing ”single commissioning leadership structures” for some areas appears to reflect a new approach to intervention.

In total nine CCGs have been placed into the financial special measures regime, and NHS England today revealed the actions it would be taking with each group:

• East Surrey CCG – organisational review to bring it together into a “single commissioning leadership structure across its area”.
• South Gloucestershire and North Somerset CCGs – directed to work with Bristol CCG “to move towards a single commissioning leadership structure across the STP footprint”.
• Coventry and Rugby CCG – Discussions are taking place with a view to creating joint leadership with another CCG, ”with a remit to develop plans for the future commissioning infrastructure in Coventry and Warwickshire”.
• Enfield CCG – will have to produce “improvement and financial recovery plan” and develop leadership “consistent with the shared management arrangements required to support implementation of the STP”.
• North Tyneside CCG – will have to review its governance and implement a financial recovery plan.
• Vale of York CCG – directed to appoint a new accountable officer, to involve NHS England in executive team and next management tier appointments, and to act on issues that have been identified “related to capacity, capability, financial governance and financial recovery”.
• Walsall CCG – Discussions are taking place with a view to creating joint management with another CCG, with a “remit to develop plans for the future commissioning infrastructure in Walsall”.
• Croydon CCG – following a deterioration in the group’s finances in the first quarter of this year, Croydon will have to produce an “improvement and financial recovery plan”, improve governance and develop leadership “consistent with the shared management arrangements required to support implementation of the STP”.

Simon Stevens said in August last year he wanted other bodies such as councils and accountable providers to be able to take over failing CCGs’ responsibilities.

He put in place an informal ban on CCG mergers in 2014, but it is understood is now in favour of some CCG mergers.

• The Commissioner: ’Iinadequate’ CCGs face intervention