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MAY 21/2014

Clinical commissioning groups: assessing their impact one year on

A year ago, NHS GPs saw a major change to the way healthcare services are organised and commissioned with the introduction of clinical commissioning groups (CCGs), marking one of the most significant components of the government's NHS reform plans.

Comprised of groups of general practices that work together to plan and design local health services across the country, CCGs were introduced to give medical professionals a greater say over how services are purchased, organised and run.

12 months later, a survey of GPs has revealed that the introduction of CCGs has been a success in many ways - but also that considerable progress still needs to be made if they are to achieve their goal of truly placing doctors and healthcare staff in full control over the direction of NHS planning.

Signs of encouragement
Published on April 1st 2014 to mark the anniversary of the enactment of the government's NHS reform programme, the report from the Nuffield Trust and The King's Fund questioned a total of 179 GPs spanning six CCGs, which were chosen to represent a wide range of different areas.

Though the findings gave a mixed picture of the success of the scheme so far, there were a number of ways in which doctors are clearly finding the new system holds advantages over the old one.

For example, GPs have kept up their overall levels of involvement with CCGs compared to a similar survey carried out last year, with 71 per cent feeling at least somewhat engaged. A large percentage of those polled also said they felt CCGs have a legitimate role to play in influencing their clinical practice, including prescribing, referrals and quality of care.

The polled doctors were also shown to be generally positive about how CCGs could change and improve general practice itself. Just over half said they felt that being part of a CCG had already improved their relations with other practices, while also changing the way they referred and prescribed.

Moreover, respondents said they felt CCGs were much more likely to listen to them than the primary care trusts (PCTs) that had previously held the same role.

Room for improvement
Despite these encouraging trends, less than 40 per cent of the GPs without a formal role believe the decisions made by CCGs reflect the views of their membership, while only one in three feel the groups are truly owned by their members.

Most of those who do hold formal roles feel they need more support, time and training to carry out their responsibilities properly, with others suggesting the implementation of the new system has led to an improvement in care quality at this stage.

Ruth Robertson, a fellow in health policy at The King's Fund, said the government can overcome these difficulties by redoubling efforts to ensure GPs are properly involved and engaged with the CCG system.

She explained: "What makes CCGs new and different is the power they give clinicians to decide how local health services are run. Without close engagement from at least a core group of GPs, this key benefit they have over their predecessor PCTs will be lost."

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