Primary Care Co-Commissioning – Governance implications

Primary Care Co-Commissioning
Presentation for CCG Board 15th January 2015
Next steps towards primary care cocommissioning – Three options
• Greater involvement for CCGs in primary care
decision-making; NHS England retain responsibility for
all commissioning decisions
• Joint commissioning arrangements where CCGs and
NHS England assume joint responsibility for an agreed
set of functions, potentially under a joint committee with
pooled funding arrangements
• Delegated commissioning arrangements where CCGs
assume full responsibility for commissioning all the
functions of general practice services, although legally
NHS England will retain residual liability so will require
robust assurance that statutory functions are discharged
effectively.
National perspective - Co-commissioning of
primary care
• GP services only (other areas for 2016/17 will be
considered)
• Performance issues/admin payments and list
management excluded
• Supports “placed based commissioning”
• Creates new opportunities e.g. locally based QOF
Our rationale for co-commissioning
• Alignment of 5 year Strategy with primary care
• Maximising opportunities for aligning incentives
• Clinical leadership and public engagement
around primary care commissioning
• CCGs have increased responsibilities for
primary care commissioning in 2015/16
Current arrangements
• Joint Primary Care Commissioning Group
– Workforce, Estates, Budgets, Local Opportunity Fund
• Primary Care Work Plan
• Next Priority – to develop a Primary Care
Strategy
What does joint commissioning mean in
practice?
 Formalise our commissioning relationship with
NHSE - A framework is to be developed setting
out details of the joint arrangements
 Provides greater ability to influence primary care
than current position
 Could include a pooled funding arrangement for
investment in primary care services
 Provides platform for moving to delegated
arrangements in future in a staged way
Governance Requirements
• CCG Constitution to be amended to allow joint
commissioning arrangements with NHSE for the
exercise of NHSE functions:
– establishment of a Joint Committee (of the Board) to
exercise primary care co-commissioning functions –
membership must have a lay and executive member
majority
– This committee should meet in public and have
representatives from HWB and Healthwatch (not
members)
Consultation and Timelines
• The membership of the CCG must be consulted
and agree any changes to the role of the CCG
as detailed in the constitution
• Build on previous engagement with practices,
LMC and other stakeholders to the support the
board decision in June 2014 regarding primary
co-commissioning
Next Steps
• Submission deadline to NHSE 30th January
• GP Forum in February will provide an
opportunity to consult regarding the cocommissioning proposals and secure agreement
to the constitutional changes
• The new arrangements would come in place 1st
April 2015.