Leaders in Greater Manchester want to commission an independent review of the current commissioning arrangements in the region.

Jon Rouse, chief officer of the health and social care devolution project, told HSJ the review could “ask questions” about the possibility of clinical commissioning groups moving within local authority structures.



CCGs in the city of Manchester already plan to merge

It would also examine the potential for more CCG and council commissioning functions to be carried out on a regional basis. The review will be launched if formal approval is given later this month.

Mr Rouse pointed to “evolutionary” changes taking place already, such as the creation of a joint leadership team between Tameside Council and Tameside and Glossop CCG, but said it “makes sense to just step back and say what is this all likely to add up to for Greater Manchester, especially with the potential for some more commissioning functions at a GM level”.

Mr Rouse said some of the current CCG functions will switch to new care model providers, which will “put the commissioning role into a much more strategic space, potentially much smaller teams and the obvious potential for the local authority and clinical commissioners to come together.

“What we’ve decided to do is bring forward proposals to undertake an independent review of the commissioning framework within Greater Manchester, and that proposal will go to the partnership board in two weeks’ time.”

Asked whether CCGs will be necessary in their current form, he said: “We are going to need high quality local commissioning and we are definitely going to need clinical leadership.

“Whether we’re absolutely going to need something which is what the CCGs are today, I don’t know, but we’ll certainly need integrated local commissioning with strong clinical leadership.”

On whether there was a case for moving CCGs into local authority structures, Mr Rouse said: “Our review is going to ask those sorts of questions. We want to avoid being over-prescriptive but also want to try and cast forwards and say look where do we need to be in three or four years’ time, whatever it might be.”

Earlier this year the three city of Manchester CCGs announced plans to merge and create a single commissioning function with Manchester City Council.

An independent report suggested this function may need to transfer to the council in the longer term, however this would be dependent on legislation and the “maturity” of the new arrangements. The council and CCGs said this was not being planned.

Leaders in Bury, Rochdale and Oldham have drawn up proposals for a joint management team across their clinical commissioning groups and adult social care services.

Mr Rouse said there is already a review ongoing around public health services in the region, such as smoking cessation, sexual health and substance misuse.

He said this will work out if there is a better way of organising services across Greater Manchester “in a way that would save money”, in order to free up resources for the front line. He added: “Maybe there are some functions which are better done once at a GM level. Some functions maybe done at a sector level, which for us is two or three or four, and others which actually should be devolved even further and embedded down at community level.”

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