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Co-commissioning of Primary Medical Care

NHS England has asked Clinical Commissioning Groups (CCGs) to consider whether they wish to engage in the co-commissioning of primary care with the NHS England Area Team. Currently NHS England holds the core primary medical care contracts while CCGs hold some primary medical care contracts for enhanced services.

What is co-commissioning?

In the latest guidance Next steps towards primary care co-commissioning (released in November 2014), co-commissioning is described as; “One of a series of changes set out in the NHS Five Year Forward View

Co-commissioning is a key enabler in developing seamless, integrated out-of-hospital services based around the diverse needs of local populations. It will also drive the development of new models of care such as multispecialty community providers and primary and acute care systems. The introduction of co-commissioning is an essential step towards expanding and strengthening primary medical care.”

What does this mean for you?

Bristol Clinical Commissioing Group (CCG) is working hard and innovatively to improve the quality of care to patients and has some ambitious plans for the next five years. Co-commissioning can support the delivery of these plans through providing a more joined up commissioning approach, especially around;

  •  delivering care closer to home for those with long term conditions,
  • addressing health inequalities, and;
  • developing integrated working across the health, social care and voluntary sector.

In addition, it will allow Bristol CCG the opportunity to support our GP member practices to drive quality improvement within primary care, support the development of sustainable services and ensure, as a membership organisation, that the CCG has a greater influence on decisions affecting primary care locally.

Levels of Co-commissioning

CCGs have been asked to indicate which level of co-commissioning they would be interested in;

  • Level 1: Greater involvement
  • Level 2: Joint Commissioning
  • Level 3: Delegated arrangements

The CCG Governing Body has been considering this and we believe Level 2, the option to jointly commission services, would provide the best opportunity for Bristol. This is because we feel it will provide the CCG the opportunity to input into important primary medical care decisions, to support sustainability in general practice and meet the CCG’s overarching objectives and those of the Five Year Forward View.

For Joint Commissioning arrangements a joint committee would be formed between the CCG and the NHS England Area Team. This would require a change to the CCG’s constitution. In the interests of transparency and the mitigation of conflicts of interest, GPs cannot be in the majority and a local HealthWatch representativeand a local authority representative from the local Health and Wellbeing Board will have the right to join the joint committee as non-voting attendees.

Next Steps

We are currently engaging with our member practices to understand their views so that a final decision can be made by the end of January 2015, when we have to submit our proposals to NHS England.

What is commissioning?