Clinical commissioning groups lack confidence in their local health and wellbeing boards’ ability to deliver change and the likelihood of the NHS making £22bn in efficiency savings.

A survey of NHS Clinical Commissioners members, shared exclusively with HSJ, found that 46 per cent of respondents did not associate their HWBs with delivering real change.

Nearly 80 per cent were not confident the NHS will achieve the £22bn in efficiency savings by 2020 seen as crucial to the success of the Five Year Forward View.

Of 350 members who responded to the survey, 103 of were chairs or chief officers, 92 were on governing bodies and the rest were managerial, administrative staff and lay members. A third of respondents said HWBs were a place for discussion and not for action, while 49 per cent of chairs and chief officers agreed this was the case “to a great extent”.

When asked whether HWBs are an environment “conducive to local decision making”, over a third said “to no extent”.

However, the survey reflected positively on CCGs’ relationships with their HWBs. Three-quarters said they associate them with partnership working , 64 per cent agreed they were a place of open discussion and 57 per cent said they were an “an equal partnership between health and social care”.

On the health service’s ability to deliver £22bn in efficiency savings by 2020, just 2 per cent of respondents said they were confident, while 79 per cent were “not very confident” or “not at all confident”.

When asked if they understood their own role in delivering efficiency savings, 26 per cent of commissioners said “not well”, 50 per cent said “fairly well” and 23 per cent said “very well”. NHS Clinical Commissioners said “this finding lays bare a disconnect between what CCGs are being asked to do and what they know will be possible and suggests they feel there is something outside of their control”.

Respondents were asked whether aspects of their operating environment had gotten worse in the last year. Nearly half said the capacity of their CCG to deliver in line with its statutory duties had. Fifty-three per cent of chairs and chief officers said the same about “the clarity of national level guidance for commissioners” and 40 per cent said the fairness of the CCG assurance process had deteriorated.

NHS Clinical Commissioner chief executive Julie Wood said: “[£22bn] is a big ask, we knew it was a big ask. It’s a big ask also in the context of no further cuts in social care funding or public healthcare funding and we’ve not actually seen that materialise so it becomes and even bigger ask.

“It’s really important if CCGs aren’t confident that actually they know how the NHS is going to deliver [savings] we support members to actually do something about that. Working with NHS England working with the other [arm’s length bodies] on how we actually get a better understanding for commissioners on what their expectations are.”