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CCG autonomy: who's in charge?

CCG autonomy: who's in charge?


One of the biggest fears CCGs hold in entering the new NHS is freedom. Or the lack thereof in this case.

Will CCGs be allowed to be locally-focused organisations and awarded the trust to make their own choices for their local population? Or are they doomed to forever fall in line with the big NHS bosses determined to rule from the centre?

CCG autonomy as been the buzzword for the past week thanks to it dominating the agenda at the first NHS Clinical Commissioners conference – a new membership body developed by the NHS Alliance, the National Association of Primary Care (NAPC) and the NHS Confederation.

It seems senior figures have been falling over themselves recently to reassure CCG members they will be part of an autonomous body.

Health Secretary Andrew Lansley recently wrote to the Chair of the NHS Commissioning Board highlighting the importance of ensuring that the decentrialisation of decision-making and promotion of the autonomy of CCGs must be “embedded within the culture of the NHS CB”.

Lansley reiterated his message, mentioning CCG autonomy more than ten times in his address to the 150 CCGs present at the conference.

The NHS CB’s Grant and Monitor Chair Dr David Bennett all seemed to understand and celebrate this principle.

So why do I still feel so uneasy when it comes to CCG freedom?

It might be something to do with the titters and exasperated sighs that came from the audience every time NAPC Chair Dr Charles Alessi continued to start every sentence or question with the assumption “As you will be autonomous organisations….” during the conference.

Or it might be that behind the big statements, the cold truth is in fact that CCGs are still struggling to assert their authority.

One CCG lead told me its PCT has refused to devolve funds required to allow them to develop a structured way to ensure providers become responsible for patient outcomes.

Another said it is being forced to deploy telehealth services against its will.

And another commissioning GP in London fears the hard work, which has already been done by the CCG during shadow operation, will be undone by PCT chiefs intent on impressing their new bosses as they move into CSS roles.

And the list goes on.

The message of CCG autonomy clearly isn’t filtering through to those still holding the purse-strings.

Many felt very reassured by Lansley’s letter to Grant but I wouldn’t breathe that sigh of relief just yet.

Question: Will CCGs continue to struggle to assert their authority going forward?


As GP Business' principal reporter, Louise Naughton has a keen interest in all things health policy and GP commissioning. Before joining GP Business, Louise covered the payments beat at a financial news company and worked as a freelance reporter on local newspapers. Louise studied journalism with sociology at City University London, where she was awarded a first class honours degree. 

Read more from Louise Naughton


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