Risk or reward?

The changing role of CCGs in general practice
Ruth Robertson, Shilpa Ross, Laura Bennett, Holly Holder, Jeni Gosling, Natasha Curry
A report from the Nuffield Trust and The King’s Fund finds that clinical commissioning groups (CCGs) risk becoming unsustainable without changes to the way they attract leaders and adequate funding to help them expand their remit.

As CCGs settle into their central role in the reformed NHS, the full scale of the challenges they face is becoming clear. This report, part of a joint project by the Nuffield Trust and The King’s Fund, aims to understand the development of CCGs, and to support them by spreading good practice and learning.

It tracks the development of six CCGs, selected to broadly represent CCGs across England. The report, which is based on a survey, interviews, observations and reviews of board papers, considers two research questions: how CCGs are functioning as membership organisations and how they are supporting the development of primary care in their local area.

The report authors found that:

  • CCG leaders questioned whether they had sufficient capacity to expand into primary care commissioning. 
  • While the majority of CCG leaders felt that conflicts of interest were being managed adequately, researchers highlighted examples of decisions where there was the potential for conflict. 
  • Few GPs felt that managing GP performance – something that contract management responsibilities under co-commissioning may lead to – was an appropriate role for CCGs. 

The study outlines a number of key recommendations to CCG leaders and NHS England to assist CCGs in making the transition to co-commissioning and ensure the sustainability of CCGs. 

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