Clinical commissioning groups

Clinical commissioning groups (CCGs) are NHS organisations set up by the Health and Social Care Act 2012 to organise the delivery of NHS services in England. 211 groups were established in 2013 and there was resistance to any proposals for mergers between groups although Gateshead CCG, Newcastle North & East CCG and Newcastle West CCG merged in 1 April 2015. During 2016 it appeared that further mergers would be permitted and an official procedure was published in November 2016 by NHS England.

To a certain extent they replace primary care trusts (PCTs), though some of the staff and responsibilities moved to Local Authority Public Health teams when PCTs ceased to exist in April 2013. Services directly provided by PCTs were reorganised through the Transforming Community Services programme.

CCGs are clinically led groups that include all of the GP groups in their geographical area. The aim of this is to give GPs and other clinicians the power to influence commissioning decisions for their patients.

CCGs are overseen by NHS England (including its Regional Offices and Area Teams). These structures manage primary care commissioning, including holding the NHS Contracts for GP practices NHS.

Each CCG has a constitution and is run by its governing body. Each has to have an accountable officer responsible for the CCG’s duties, functions, finance and governance. Most CCGs initially appointed former PCT managers to these posts. Only a quarter of accountable officers were GPs in October 2014, but 80% of CCG Chairs were GPs. Only half of GP practices said they felt involved in CCG decision making processes. The Health and Social Care Act 2012 provides that the areas specified in the constitutions of clinical commissioning groups together cover the whole of England, and do not coincide or overlap. Each CCG is responsible for persons who are provided with primary medical services by a member of the group, and persons who usually reside in the group’s area and are not provided with primary medical services by a member of any clinical commissioning group.

E-reward, an online pay research service, analysed the pay of more than 2,500 managers at the 211 CCGs in England in 2015. They reported that 56% of 225 top executives – chief officers and chief finance officers – were paying themselves more than the salary range recommended by NHS England of £95,000 to £125,000 a year.

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