Clinical Commissioning Groups

Clinical Commissioning Groups

Due to the complexity and scale of the healthcare system, the Government believes it is more efficient to plan and commission healthcare at a population level, such as a town and its surroundings or a metropolitan borough.

As a consequence of this, all GP practices are required to be a member of a clinical commissioning group (CCG). CCGs provide the organisational infrastructure to enable GPs, working with other health professionals, to commission services for their local communities.

CCGs’ governing bodies have GP, nurse and secondary care representatives, as well as at least two ‘lay’ members who are not NHS professionals. The services that CCGs commission include planned hospital care, rehabilitative care, urgent and emergency care (including out-of-hours and accident and emergency services), most community health services, maternity services, mental health and learning disability services.

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.

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.

These regulations set out the detailed provisions relating to CCGs, and 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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