Clinical Commissioning Groups

Clinical Commissioning Groups

Clinical commissioning groups (CCGs) were established on 1 April 2013 and are clinically-led organisations at the heart of the NHS system. CCGs commission most of the hospital and community NHS services in the local areas for which they are responsible.

The NHS commissioning system was previously made up of primary care trusts and specialised commissioning groups. Most of the NHS commissioning budget is now managed by CCGs. These are groups of general practices which come together in each area to commission the best services for their patients and population. All GP practices now belong to a CCG, but CCGs also include other health professionals, such as nurses.

In order to plan their commissioning decisions, local authorities and CCGs (coming together through Health and Wellbeing Boards) use Joint Strategic Needs Assessments (JSNAs) and Joint Health and Wellbeing Strategies (JHWSs) to agree local priorities for local health and care commissioning.

Services CCGs commission include:

  • most planned hospital care;
  • rehabilitative care;
  • urgent and emergency care (including out-of-hours);
  • most community health services; and
  • mental health and learning disability services.

For community pharmacy, CCGs may wish to commission services such as minor ailments services, palliative care schemes, MUR+ and other medicines optimisation services. 

The NHS (Clinical Commissioning Group) Regulations 2012

These regulations were laid before Parliament on 26 June 2012 and set out the detailed provisions relating to CCGs. They include:

  • Details as to membership (including those who are ineligible);
  • The naming of the CCG; and
  • Governance arrangements.

The names of CCG must follow a statutory format, beginning with NHS, then a geographical description, and ending with ‘clinical commissioning group’.

The CCG’s governing body must have at least six members, including its chair and deputy chair.

The CCG’s governing body must also include the CCG’s accountable officer; an employee of the CCG who has a professional qualification in accountancy and expertise to lead the financial management (the chief finance officer); a registered nurse (who must not be employed by, or be a member of a primary medical services contractor or any other provider of services to the CCG; a secondary care specialist (but who is not a provider of services to the CCG); a lay person who has qualifications or experience in financial matters; and a lay person who has knowledge of the CCG’s constitution, and is able to express informed views about the discharge of the CCG’s duties.

The Schedules to the Regulations further set out the lay persons who are not to be considered lay persons for the purposes of the above, and other persons who are disqualified from being members of the CCG’s governing body (the schedule lists MPs, members of local authorities, any individual or organisation and their employees that provides services to support the CCGs in discharging its commissioning functions).

The CCG must have an audit committee, chaired by a suitably qualified or experienced lay person and a remuneration committee also chaired by a lay person.

Transparency requirements include a duty to publish all its meetings papers, unless that would not be in the public interest to do so.  It must publish (subject to banding) the remuneration, fees and allowances of each senior employees of the CCG. 

Related resources

PSNC Briefing 066/13: Working with CCGs and GPs – a suggested checklist for LPCs (June 2013)
This PSNC Briefing contain a suggested checklist for LPCs related to working with Clinical Commissioning Groups (CCGs) and GPs. 

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