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Exclusive: Commissioners feel unable to influence policy

Exclusive: Commissioners feel unable to influence policy

Clinical commissioners do not feel they are very able to influence policy decisions, an insightful new survey revealed
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Clinical commissioners do not feel they are very able to influence policy decisions, an insightful new survey revealed.

The poll – from the research division of The Commissioning Review’s publishers, Cogora – gathered the views of 1,158 commissioners, GPs, and nurses in order to better understand the current state of the NHS.

Surprisingly, even commissioners – while giving a higher rating than other professional groups –  did not rate themselves as being very able to influence policy decisions (median rating of three out of five, where five is the highest).

One reason for the low ratings could be the bureaucracy and regulations governing clinical commissioning groups (CCGs). As noted by Dr Joe Gilligan, GP and LGA health and wellbeing champion, “it is very difficult to affect a change with all the rules and regulations and threats of judicial reviews if any major service change is contemplated”.

This is in line with opinions three years ago. In May 2013, think-tank The King’s Fund responded to the House of Commons Select Committee's inquiry into the implementation of the Health and Social Care Act 2012.

It stated: “Although there is encouraging evidence of collaboration between CCGs, we remain concerned that the fragmentation of commissioning and lack of strategic responsibility in the new system for leading large-scale reconfigurations will make service changes more difficult to implement.”

The survey also found that GPs feel unable to influence their CCGs' policy decisions, a survey found, even though the 2012 Health and Social Care Act was meant to put GPs at the forefront of commissioning.

While the introduction of CCGs was meant to increase GPs’ influence on commissioning, little more than a third of respondents (36%) believed this to have happened.

Interestingly, Cogora’s research showed there was a notable discrepancy in the answers provided by commissioners and GPs. While almost four-fifths of commissioners (78%) believed GPs to have gained more influence over commissioning, only one-quarter (27%) of GPs agreed with this. More than one-half of GPs (57%) disagreed.

Read the full report here

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