NHS reforms update: DH provides guidance on authorisation process for GP consortia

The Department of Health (DH) has laid out key details of the planned authorisation process for clinical commissioning groups (CCGs), as well as announcing a number of support tools that will enable GPs to gauge the likelihood of their organisations meeting all the criteria.

The creation of highly-effective, high-quality authorised clinical commissioning groups is at the heart of driving improvements for our patients in the NHS and delivering value to the taxpayer

Dame Barbara Hakin, national managing director of commissioning development in England, said: "We have been working with a number of groups including pathfinders, strategic health authorities (SHAs) and patient representatives to discuss how we can move from the current position of vibrant and enthusiastic pathfinders to established CCGs. We have been thinking particularly about the authorisation domains and principles which the NHS Commissioning Board will be working through with the CCGs to enable them to become fully authorised."

The framework shows CCGs will be judged on a number of areas, including:

• They must be able to show strong clinical and professional focus which brings real added value
• They must have meaningful engagement with patients, carers and their communities
• They must have clear and credible plans that continue to deliver the QIPP challenge within available financial resources and in line with national outcome standards and local joint health and wellbeing strategies
• They must have proper constitutional and governance arrangements with the capacity and capability to deliver all their duties and responsibilities including financial control, as well as effectively commission all the services for which they are responsible
• They must have 'great leaders' who can make a real difference both individually and collectively

Dame Barbara said: "The creation of highly-effective, high-quality authorised clinical commissioning groups is at the heart of driving improvements for our patients in the NHS and delivering value to the taxpayer.

"The next few months will be extremely busy in terms of the work we do to set up successful, supportive arrangements for the new commissioning system."

Among these arrangements is the development of a self assessment tool to enable emerging CCGs to understand and reflect on their values, culture, behaviours and wider organisational health.

An interactive computer-based product, it allows leaders to assess the capability of their organisations and identify any developmental needs. Currently available as an interactive spreadsheet, by the autumn it will be a fully web-based service.

The framework states: "The tool is intended to encourage conversation about the roles and responsibilities that will be expected of CCGs as statutory bodies and their readiness to take these on. While it includes some of the key areas that are likely to be required for authorisation, it also provides insight into how you can create vibrant organisations that can continually improve beyond the point of authorisation.

"We would commend its use to emerging CCGs early on in their journey to support their organisational development journey over the next 12-18 months."

A number of other supplementary documents are also being made available over the coming months, including:

• Guidance on the delegation of commissioning responsibilities and how the process for budget delegation will be tracked across the NHS
• Guidance on the legal status of pathfinders and shadow CCGs to provide clarification on the proposed legislative framework
• An update on The Functions of GP Commissioning Consortia originally published in March and reflecting the changes to the Health and Social Care Bill in light of the recent NHS Future Forum feedback report

In addition, the DH has commissioned an independent evaluation of the pathfinder programme, which has so far adopted 257 organisations covering 97% of the population. The study will be led bythe London School of Hygiene and Tropical Medicine and the University of Manchester and will enabling feedback from pathfinders to be shared more widely. It will also advise the NHS Commissioning Board on the key factors it will need to address in the support it provides to CCGs over the next two years to ensure their readiness to assume responsibility for commissioning in 2013. Initial findings are expected in December, with more details due in June 2012.

Also included in the announcement this week are the first details of the naming structure that will be used by CCGs. The document states: "The intention is that a governance framework will be made available in the autumn. This will include details of how groups should be named and branded both pre and post authorisation. In the meantime, wherever possible, groups should hold off making naming and branding decisions that may have to be reversed at a later date. If this is unavoidable, groups should choose an interim name that is clear and descriptive."

For more details of the plans, click on the link below to read the announcement in full.