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CCG Series: Innovation and suspicion

CCG Series: Innovation and suspicion


East Surrey CCG has always been at the forefront of clinical commissioning. It has survived every bureaucratic barrier that has been put its way. It formed a Limited Liability partnership during the Practice Based Commissioning days and endured an enforced change of name from ESyDoc to East Surrey Clinical Commissioning Group. It has shrunk from twenty practices to eighteen not because of defection, but the harsh economic reality of financial sustainability which is facing us all. Two practices have either closed or merged.

East Surrey CCG has always prided itself on putting the patient first and challenging the status quo. Thinking differently, looking in the mirror before questioning others, exploring new ways of working.

In 2009 we did a contest between several pharmaceutical companies to partner with us on a COPD redesign project. AstraZeneca were chosen and a very successful project resulted in better integrated care for patients with COPD. It was recognised nationally and internationally as good practice and mentioned by previous Health Secretary Andrew Lansley as something he wanted to see more of in the NHS. Sadly in this country we suffer from the “tall poppy syndrome" where anyone who seems to be doing better has to be cut down to size. Rather than embracing this new way of working, our beauty contest was viewed with suspicion and envy because it appeared we were working with and 'seduced' by the dark side -  the private sector.

Undeterred, in 2011 a new project was started looking at asthma because many assumed that the problem had already been fixed. In a joint project between East Surrey CCG, the Department of Health and Astra Zeneca, the whole adult asthma care pathway was reviewed and new ways of working were determined. Using risk stratification tools and nurse-led clinics there was an impressive 29% reduction in acute asthma admissions. 

I had the honour of presenting this joint working approach at the NICE conference in Birmingham to a lunchtime workshop organised by the ABPI. The sad thing was that what I presented is nothing new. The NHS is brilliant at new ideas but suffers from pilotitis! The good ideas struggle to be formally integrated into  daily working life and the champions either lose faith or have moved on to new projects.

What I learnt at the meeting was that the fundamental flaw in all the projects is getting across the WHY. Why undertake them, why swim against the tide of custom and practice? The reason is to improve patient care and to be proud of doing a good job, irrespective of which industry you are representing.

It was no coincidence that the NHS was a major feature at the Olympics. I believe it is fundamentally right in its principles and values and can be the engine that drives the economy out of recession. By embracing new ways of working and getting the “why” right I think the NHS will rise out of the ashes of the Francis report and start to deliver the best outcomes in the world. This will take time, patience and trust.

There is now enough guidance and safeguards to enable us to do the right thing.

By working together we will do it right.   


If your CCG has something to share, don't hesitate to contact Lalah-Simone Springer ( for more information on contributing to the CCG Series


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