STRUCTURE: NHS Surrey has identified a list of 14 “key risks and issues” it faces in the transition of commissioning responsibility to clinical commissioning groups.

It said the number of risks it had identified in the system was down to its new risk based approach to manage the transition coupled with more guidance and clarity being provided on what was expected.

Many of the risks identified relate to staff transfers from the primary care trust to the new commissioning support structure, including the likelihood of redundancies and its impact, for example, on “corporate memory”.

Latest board papers describe the key risks and issues to transition as follows:

  • HR process, mapping and risk of redundancies. Hope to give staff clarity and provide estimate of redundancy risk by end of September
  • CSU risk relating to establishment and relationship with CCGs
  • CCG ability to do their task (planning, QIPP etc)
  • September is key month for work to be completed, namely, contract stabilisation, quality document, deadline for estates, and capacity may be an issue
  • Difficulty being experienced in setting up CCG performance management meetings. This needed to be done urgently, but would have to take cognisance of the impact of LATS taking responsibility from 1st October
  • For CSU to be viable there must be economies of scale and with 51 per cent of staff aligned for transfer to the CSU there is a big risk of redundancy
  • CSU is at risk that CCGs have preference for alternate providers of commissioning support. It was agreed that the HR Director would take up with Commissioning Support South, the possibility of TUPE applying if work is coming from Surrey
  • The impact of hosting by the CSU by the NHS CB from 1st October 2012
  • Finalisation of the CSU customer base is needed in order to move the CSU forward.
  • Loss of corporate memory
  • Ascertaining which CCG picks up the costs of redundancy, particularly where they have opted not to use NHS Quality Woks
  • CCG/CSU non-agreement means authorisation process is difficult
  • Finalisation of financials and new structures
  • CCG competence as receivers of quality functions. Key is that the Cluster has back up of the knowledge to ensure it is not lost