A Quick Guide to CCGs for UK Healthcare Market Research
What are CCGs?
Clinical Commissioning Groups (CCGs) were established following the introduction of the 2012 Health and Social Care Act, replacing Primary Care Trusts (PCTs) as the organisations responsible for the delivery of a large percentage of healthcare services for the population in their local area.
Led by General Practitioners, and supported by a range of other healthcare professionals, CCGs work closely with a range of other public and private bodies, including local authorities and the voluntary sector, to plan, commission and deliver services.
How is a CCG organised?
CCGs each have their own constitution and governing bodies, and they are accountable to NHS England. There are currently 211 CCGs throughout England, with different organisational structures in place across Scotland, Wales, and Northern Ireland.
What does a CCG do?
The role of CCGs has continued to evolve since their introduction in 2013. At the outset, CCGs were responsible for commissioning a wide range of services relating to rehabilitation care, urgent and emergency care (including all A&E admissions), community health services, and mental health and learning disability services for all individuals who were registered within their geographical boundary. They were also responsible for all aspects of the commissioning of elective care.
Changes in the national healthcare landscape, driven by the Health and the Social Care Act, took the responsibility of commissioning certain services out of CCGs and into the hands of a number of other public bodies. Public health teams, based in local government, now have statutory responsibility for the commissioning of the NHS Health checks programme, the National Child Measurement Programme, sexual health services, and drug and alcohol misuse services. NHS England assumed all commissioning responsibilities for locally delivered immunisation and screening services, as well as all services delivered via primary care.
How much say do CCGs have in the care we receive at our GP practice?
In 2014, CCG responsibilities changed again when they were invited to become’co-commissioners’ of primary care, with around a quarter of CCGs nationally accepting this role and beginning to play an increasingly greater part in influencing and changing the shape of primary care in their areas. Additionally, around another 65 CCGs nationally were given full responsibility for all primary care services, resulting in around 70% of all CCGs throughout England being involved in primary care planning in some capacity. CCGs also deal with a range of other issues such as individual funding requests (for particular treatments or pharmaceutical products).
What does the future hold for CCGs?
The future of CCGs presents a number of significant challenges and opportunities. The new primary care commissioning responsibilities are welcomed by many General Practitioners, who feel that they are well placed to know what’s best for their patients and that having commissioning responsibility puts them in the driving seat. However, many GPs have expressed concern regarding the means by which they are held accountable, arguing that the old performance management process used in PCTs should be replaced by more investment in GP training, education, and reviewing comparative data to identify areas for improvement.
The efficiency savings target, set by the government at ë£22bn over the course of the next 5 year government, has presented an unprecedented challenge as to how CCGs decide to allocate and spend their allocated budget. This has been exacerbated by further cuts in social care and public health budgets in local authorities, both of which are forecast to place considerable strain on NHS services and the overall healthcare system in due course.
Are there any other changes that CCGs have to take into account?
As many CCGs continue to review their services in light of the financial savings that must be made, there is some concern that particular services will be deemed surplus to requirements, or services that are regarded as successful but not underpinned by a significant evidence base will disappear. Changes in demography also present a significant challenge to the way in which CCGs commission and deliver their services.
An increasing ageing population, often with complex needs that require the support of a number of different healthcare professionals, will make it difficult for CCGs to deliver on their aims of the best quality healthcare for all due to the organisational complexities of turning a vision around integrated health and social care into an operational reality. Many CCGs have also faced criticism over their lack of involvement with the public and patients in the design and delivery of healthcare services, and making insufficient use of the Patient and Public Advisory Groups (PPAGs) that form a statutory part of each CCGs constitution.
Can CCGs continue to meet the needs of their local population?
The new demands placed on many CCGs through their additional commissioning responsibilities and the financial squeeze has had an understandable impact on the workforce, with existing healthcare market research suggesting that many employees feel that things may get a lot harder before they begin to get better. Recent studies have shown that many CCGs face a number of significant challenges regarding their sustainability in the current climate regarding resources, finances, and staff expertise – only time will tell if they can weather the storms of the future and develop the right solutions to meet their patient’s needs.
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