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CCG Series: Debate, challenge, demonstration for Liverpool CCG

CCG Series: Debate, challenge, demonstration for Liverpool CCG


In the first blog from our CCG Series, which creates a platform for CCG chairs to share best practice, Dr Nadim Fazlani Liverpool CCG  chair discusses local involvement with commissioning and lays out his hopes for the future.  

The journey to being a statutory body in Liverpool was anything but uneventful. In Merseyside we’re activists with strong opinions, which has been reflected in our involvement in commissioning from fund holding and total purchasing pilots to practice based commissioning. We’ve been through a journey that was reflected around the country – the four practice based commissioning consortia became one Clinical Commissioning Consortium in June 2012. Representatives to the governing body and the three localities were elected with one person one vote, supervised by Liverpool LMC and the turnout was high. 

Our governing body meetings are held in public and sometimes the observers outnumber governing body members. We’ve already had our first public demonstration at a governing body meeting, which tend to be well attended and usually have some debate and challenge. I can honestly say as I talk to people round the country that Liverpool seems to be second to none in clinical involvement.

In Liverpool clinicians were very much involved in commissioning from the practice based commissioning (PBC) days and clinical engagement was not an issue - opinions were voiced strongly in open and closed meetings. Although we wanted to be authorised in wave one, we were authorised in wave four, but this was not an issue for us. We wanted to focus on doing our day job, to tackle the health challenges in Liverpool. The transfer of responsibilities and delegated budgets which had been happening since the PBC days accelerated as we became more mature as a commissioning body. The challenge is being faced together with Liverpool City council in a partnership that has existed from the Liverpool PCT days. Now the relationship is much stronger and with the introduction of the health and wellbeing board we are developing a true partnership with city council. 

Liverpool, along with number of other Northern cities is facing major cuts in funding.

However Liverpool is the only city outside London which has an elected Mayor. Both Joe Anderson and London mayor Boris Johnson have health as part of their portfolios and this in Liverpool is a added dimension.

The last couple of weeks have been very eventful, the introduction of non-emergency number 111 was one challenges where we felt the rules kept changing and sometimes the connection with reality on the ground was lost. However the prospect of a £25,000 fine per day unless we demonstrated our readiness for the launch meant we did our best to work with Department of health. On 21st March, when we launched, the issues which had been previously been highlighted came true.  

I hope this isn’t a sign of things to come but I believe that clinical commissioning will bring better services for patient in the climate of financial challenge. 

Whether this is optimism or delusion, only time will tell.  


If you want to take part in the CCG Series, please email 


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