The changing face of clinical commissioning

The changing face of clinical commissioning
NHS Clinical Commissioners 23 May 2019

• The report highlights the work of CCGs to drive through innovations and improvements across health and social care and the key strengths which should be retained within the new structures proposed by the NHS Long Term Plan.

Workforce Disability Equality Standard

NHS Workforce Disability Equality Standard Technical Guidance
NHS England 27 March 2019

• The WDES will help NHS organisations to review their performance against ten (10) Metrics and produce action plans to close the gaps in career and workplace experience between Disabled staff and non-disabled staff. This Technical Guidance contains the WDES Metrics, and provides a range of detailed information that will support those tasked with implementing the WDES.
• The Standard that will apply to all NHS Trusts and Foundation Trusts from April 1 2019.
• The roles that CCGs are expected to play in rolling out, supporting the WDES and/or implementing the WDES as employing bodies will be agreed as part of the new IAF. Discussions about the 2019/20 IAF and the WDES will take place in 2019. 

Workforce Disability Equality Standard
NHS England February 2018

• The Workforce Disability Equality Standard (WDES) is a set of metrics that will enable NHS organisations to compare the experiences of disabled and non-disabled staff. 
• The first WDES reports for NHS Trusts and Foundation Trusts will be published in August 2019, based on data from the 2018/19 financial year.

CCGs - House of Commons Public Accounts Committee

Clinical Commissioning Groups 
House of Commons Committee of Public Accounts, 8 March 2019

• An examination of the work of CCGs and the impact of the NHS Long Term Plan on the future of CCGs.
• Recommendations relate to CCG performance and accountability, an update on the relationship between CCGs and Integrated Care Systems, expected number of CCGs, estimate of CCGs redundancies, input of local GPs into CCG decision making, CCG focus on the needs of larger population groups, and legislative changes.

Report summary and recommendations:

A review of the role and costs of CCGs

A review of the role and costs of clinical commissioning groups
NAO 18 December 2018

• This review sets out:
• changes to the commissioning landscape before CCGs were established;
• the role, running costs and performance of CCGs; and
• the changing commissioning landscape and the future role of CCGs.
• "There has been a phase of CCG restructuring with increased joint working and some CCGs merging. If current trends continue, this seems likely to result in fewer CCGs covering larger populations based around STP footprints. This larger scale is intended to help with planning, integrating services and consolidating CCGs’ leadership capability. However, there is a risk that commissioning across a larger population will make it more difficult for CCGs to design local health services that are responsive to patients’ needs, one of the original objectives of CCGs."
• "It is ... important that the current restructuring of CCGs creates stable and effective organisations that support the long-term aims of the NHS. Following almost three decades of change, NHS commissioning needs a prolonged period of organisational stability. This would allow organisations to focus on transforming and integrating health and care services rather than on reorganising themselves. It would be a huge waste of resources and opportunity if, in five years’ time, NHS commissioning is going full circle and undergoing yet another cycle of restructuring."
• The role of commissioning support units para 4.8-4.11.
• 4.10 Income to CSUs reduced from £810 million to £500 million between 2013-14 and 2017-8 
• 4.11 As the NHS commissioning landscape continues to change, with increased integration and the potential for larger-scale commissioning organisations, the requirements for external commissioning support may change further. NHS England stated that it is confident that the business cases for all five commissioning support units demonstrate their ongoing viability.

CCG admin budgets to be cut by 20 per cent

CCG admin budgets to be cut by a fifth
HSJ 26 November 2018 (subscription required)

• HSJ has reported that a letter sent to CCGs by NHS England ahead of the long term plan, has said that “administration” limits will be introduced for each CCG in the next financial year, and they must reduce admin budgets by 20 per cent.
• According to the letter one of the ways "suggested" by NHS England is closer working with CSUs to cut costs, CCGs must simplify payments to CSUs and move away from payment by results.
• The letter from Matthew Swindells, deputy chief executive at NHS England, and regional directors, said CCGs can save money by “exploring mergers and joint ways of working”. To support this, it said it will now approve mergers throughout the year rather than once a year, as is currently the case. It said: “[It] will particularly support approaches which align a single CCG with a single ICS.”
• The letter also confirmed the new regional NHS England structure will support the development of ICS and sustainability and transformation partnerships.

CCG mergers to take effect from 1 April 2018

CCG Bulletin

NHS England 15 March 2018

• NHS England has confirmed the conditions have now been met to enable 18 existing CCGs to merge from 1 April 2018. The existing CCGs will be dissolved and six new CCGs will be formed from existing CCGs. 
• The new and (former) CCGs are:
• Birmingham and Solihull CCG (Solihull CCG, Birmingham Cross City CCG and Birmingham South Central CCG) 
• Bristol, North Somerset and South Gloucestershire CCG (Bristol CCG, North Somerset CCG, and South Gloucestershire CCG) 
• Buckinghamshire CCG (Aylesbury Vale CCG and Chiltern CCG)
• Berkshire West CCG (South Reading CCG, North & West Reading CCG, Newbury & District CCG and Wokingham CCG)
• East Berkshire CCG (Windsor, Ascot & Maidenhead CCG, Bracknell & Ascot CCG, Slough CCG) 
• Leeds CCG (Leeds North CCG, Leeds South & East CCG, and Leeds West CCG).
• Following the mergers, there will be a total of 195 CCGs in England.

NHS workforce race equality: a case for diverse boards

NHS workforce race equality: a case for diverse boards
NHS England 12 March 2018

• This report highlights the importance of inclusive boards in the NHS (including CCGs) and provides guidance on working towards creating inclusive cultures.

Conflicts of interest indicator: submission process for CCGs

Conflicts of interest indicator: submission process for CCGs
NHS England 13 February 2018

• This document provides further information on the conflicts of interest indicator in the CCG Improvement and Assessment Framework, and the process for completing and returning the self-certification submissions, including updated templates.