In case you didn’t know, Clinical Commissioning Groups (CCGs) are taking over from the old PCTs (Primary Care Trusts). Our local CCG is the “Sarum NHS Alliance”.  However it seems that the Sarum NHS Alliance is merging with other Wiltshire CCGs to form one county wide CCG.

The news report linked below indicates that the merger is due to the work loads involved and to the need to avoid a “post code lottery”.  This last point is interesting because it is exactly what the previous , chief executive of Salisbury NHS Foundation Trust, Matthew Kershaw, admitted the reforms could lead to.

In an article from last year (see link below). Kershaw discussed the risk that neighbouring CCGs could offer different levels of service, refuse to provide certain treatments or allow longer waiting lists for more expensive treatments.  Conversely he warned of the possibility of CCGs merging together to provide a more uniform service in an area but that this would undermine and prevent the competition that the Government is aiming for.  Interesting issues – see link below for more details.

The new CCG will operate in shadow form and work closely with NHS Wiltshire this year before it takes over the reins in April 2013.

So What are Clinical Commissioning Groups?

Clinical Commissioning Groups are groups of GPs that will, from April 2013, be responsible for designing local health services In England. They will do this by commissioning or buying health and care services. (There is also the NHSCB and the four SHAs but more of those in a future post).  Apparently, aboard of 5 GPs and 2 non GPs was formed last April to run a Clinical Commissioning Group based around Salisbury Hospital, called Sarum NHS Alliance. It consists of 27 practices and approximately 150,000 patients.

This all sounds great – who better to control our health service than dedicated well known and trusted local GPs.  Unfortunately it might not turn out like that in the long run – the kind of GP who is dedicate to his/her patients and the community is unlikely to enjoy the management and committee work of a CCG.  Evidence is already appearing which indicates that CCGs are likely to end up consisting disproportionately of GPs who own stakes in non-NHS providers and could use their decision-making power to simply commission their own companies to offer services.  Here is an example. I stress that I have no reason to believe that any of this is true for our local CCGs and am sure that those that have got involved have done so for the best of reasons – to ensure that they can adapt and guide  the reforms for the benefit of their local communities. However, we all need to be vigilant to ensure that we spot the conflicts of interest that could develop in the long term.

News:
A Salisbury GP has resigned as chair of Sarum NHS Alliance commissioning group. The Doctor, who was previously heavily involved in practice-based commissioning, said ‘The CCG role was becoming too much. I had to make a choice and in the end my priority was my patients’:  http://www.pulsetoday.co.uk/newsarticle-content/-/article_display_list/13150087/gps-quit-ccg-roles-as-commissioning-enthusiasts-lose-heart

NHS reforms ‘risk’ creating a postcode lottery: http://www.onmedica.com/viewsArticle.aspx?id=ab2354d4-b1b2-4b85-8cbf-c7f3bf68ea98

Three Wiltshire CCGs (including Sarum NHS Alliance) to merge:  http://www.gazetteandherald.co.uk/news/9628367.Three_Wiltshire_CCGs_to_merge/

Half of GPs on clinical commissioning groups have financial links with private providers:   http://www.pulsetoday.co.uk/newsarticle-content/-/article_display_list/13150087/gps-quit-ccg-roles-as-commissioning-enthusiasts-lose-heart