Clinical Commissioning Groups (CCGs) were created following the Health and Social Care Act in 2012, and replaced Primary Care Trusts on 1 April 2013. CCGs are clinically-led statutory NHS bodies responsible for the planning and commissioning of health care services for their local area. There are now 211 CCGs in England.
Commissioning is about getting the best possible health outcomes for the local population, by assessing local needs, deciding priorities and strategies, and then buying services on behalf of the population from providers such as hospitals, clinics, community health bodies, etc. It is an ongoing process, and CCGs must constantly respond and adapt to changing local circumstances. CCGs are responsible for the health of their entire population, and are measured by how much they improve outcomes.
- Membership bodies, with local GP practices as the members;
- Led by an elected Governing Body made up of GPs, other clinicians including a nurse and a secondary care consultant, and lay members;
- Responsible for about 60% of the NHS budget; or £60 billion per year;
- Responsible for healthcare commissioning such as mental health services, urgent and emergency care, elective hospital services, and community care;
- Independent, and accountable to the Secretary of State for Health through NHS England;
- Responsible for the health of populations ranging from under 100,000 to 900,000, although the average population covered by a CCG is about a quarter of a million people.
CCGs work with closely with NHS England, who has three roles in relation to CCGs. The first is assurance: NHS England has a responsibility to assure themselves that CCGs are fit for purpose, and are improving health outcomes. Secondly, NHS England must help support the development of CCGs. Finally, NHS England are also direct commissioners, responsible for highly specialised services and primary care. As co-commissioners, CCGs work with NHS England’s Local Area Teams to ensure joined-up care.
As Local Authorities are now responsible for public health, CCGs work closely with them through Health and Wellbeing Boards to achieve the best possible outcome for the local community, by developing a joint needs assessment and strategy for improving public health.
Commissioning Support Units (CSUs) help provide support and services for CCGs such as finance, HR, data management, or contracting. CCGs can choose to buy services from CSUs or to do them in-house, whichever they feel is most efficient and appropriate. CSUs are currently part of NHS England, but are to become private companies by 2015.