One in three clinical commissioning group leaders are unhappy with the commissioning support arrangements that have been made for them so far, according to an EHI Primary Care survey.
The exclusive poll, which ran throughout April and attracted more than 90 responses from GPs, emerging CCG chairs, board members, IM&T leads and others involved in commissioning, found 35% were ‘not satisfied’ with current plans to provide them with commissioning support.
Almost half (47%) said they were ‘quite satisfied’ and a further 18% reported that they were ‘very satisfied’.
The findings come against a background of controversy about CSSs. Some emerging CCGs have complained that they are being forced to use their local CSS for ‘back office’ functions and services such as IT and information analysis and support.
These CCGs would rather look to the private sector. But the BMA is concerned that this will lead to the effective “privatisation” of commissioning – a fear expressed by the National Local Medical Committee Conference last week.
The EHI Primary Care survey found that 44% of respondents already have plans to work with their local CSS because of previous good relationships with PCT support staff. But 23% felt that that had no choice about using their local CSS.
Nearly a third (29%) said they had yet to make a decision about commissioning support and 3% said they planned to go outside the NHS for a better quality service.
David Cripps, a practice manager and board member of West Suffolk CCG, told EHI Primary Care that his area had opted to go for providing commissioning support in-house in a shared arrangement with neighbouring CCG, Ipswich and East Suffolk.
Most of the staff will come from the PCT, but Cripps argued that a change in culture will be needed. He added: “Suffolk has some very useful people and ensuring that we don’t lose them was very important.
“But we will see how that runs. It depends on whether the tail is going to wag the dog or the other way round. I’m going to be very keen that the dog wags the tail.”
Just over one in ten of respondents (12%) said they also expected to get some IT support from non-NHS organisations after 2013, and 11% predicted they would also use information and analysis services from outside the NHS.
Most emerging CCGs identify their key task for the next nine months as achieving authorisation to proceed, with the overwhelming majority (96%) predicting that they will be authorised by April 2013.
The survey found that 50% of CCGs have already formed at IT working group and appointed an IT lead and 25% have developed an IT strategy. Three out of four (75%) said they were also hoping to secure some in-house IT support in the next 12 months.
Dr Saj Azfar, Rochdale GP and clinical IM&T lead for Heywood, Middleton and Rochdale CCG, said he was in the process of putting together a strategy for his organisation. He said local CCGs had been invited to work with the Greater Manchester CSS, as it put together its own business case for approval.
He told EHI primary Care: “The biggest issue for us is what will happen in that transition phase after 2013 as we start to get to grips with commissioning.”
Dr Azfar said it would be a challenge to achieve authorisation by April 2013 and to manage the transition after that.
He added: “I’m not despondent about it because we have good working relationships with colleagues in community and secondary care and we hope we can retain a number of good people from the NPfIT era.”
Nearly half of respondents (44%) said they were already working with other CCGs on IT with the remainder predicting that they would do so in the next 12 months. While only 21% had already established an IT budget, 79% said they would have done so by this time next year.
Read more about the survey and respondents’ views of CSSs in the Insight section.