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CCG Series: On losing our CSU

CCG Series: On losing our CSU

2 September 2013

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From 'I told you so' to 'Now what?' – CCG lead Dr Joe McGilligan explains the hard process of getting over losing your CSU in this latest installment of the CCG Series

From 'I told you so' to 'Now what?' – CCG lead Dr Joe McGilligan explains the hard process of getting over losing your CSU in this latest installment of the CCG Series
In September last year I was quoted in several publications raising my concerns about the sustainability of Surrey and Sussex CSU after four of the six CCGs in Surrey selected other CSUs. I then rode the wave of hostility from many quarters for questioning the process and the people. The next six months I was reassured by the then managing director all would be well – however as a CCG with conditions and a legal direction we were heavily reliant on our CSU to help get them removed and make us a fully functioning organisation. In April 2013, just as we took up our statutory obligations Surrey and Sussex CSU were deemed unviable by their new managing director. 
It was no secret that Surrey PCT had its problems and all the contracts we were inheriting were novated to us to continue for a further six months whilst the new CSU could address them and ensure they were fit for purpose and in line with our commissioning plans. It is critical that we get the contracts right to ensure we hit our QIPP plans and statutory responsibilities. The CCG took a sensible and honest approach to our plans and posted a deficit plan for this year, with a clear plan to break even in three years.
The transition from PCTs to CCGs has had a variable journey country wide. In some areas it has been seamless, in others quite challenging. Where relationships were not great and there was some bad blood it did not have time to dry before the roles changed. It is now clinically led and managerially enabled but sometimes the behaviours of individuals take longer to change. I have a saying: “Be careful which toes you tread on today because they may be on the feet kicking your butt tomorrow.” The transition has been difficult for some individuals on both the managerial and clinician side of the equation. The CCGs are the customers, buying services from the supplier CSUs and if the provision is not what was ordered in terms of quality or affordability then the CCG can eventually look elsewhere – which is a new concept – but at the moment our hands are tied.
Having met with the NHS England Business Development Unit I have a renewed optimism that the transition to our next CSU will resolve many of the issues we are struggling with. I have enormous sympathy for the individuals who have been through the storming and forming of one CSU only to find they again have to go through the job matching process with no certainty of successful placement.
I am the eternal optimist that this is an event all can learn from and we can develop a core offer from the NHS. Our patients deserve the best healthcare which will happen when the local commissioning plans of CCG’s are enacted and delivered. We all have the responsibility to ensure the public pound is spent most efficiently and effectively, irrespective of which organisation we sit in. Organisations compete whereas individuals collaborate. 

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