Primary care-led commissioning: applying lessons from the past to the early development of clinical commissioning groups in England


Checkland, K; Coleman, A; McDermott, I; Segar, J; Miller, R; Petsoulas, C; Wallace, A; Harrison, S; Peckham, S; (2013) Primary care-led commissioning: applying lessons from the past to the early development of clinical commissioning groups in England. The British journal of general practice, 63 (614). E611-E619. ISSN 0960-1643 DOI: https://doi.org/10.3399/bjgp13X671597

Full text not available from this repository. (Request a copy)

Abstract

Background The current reorganisation of the English NHS is one of the most comprehensive ever seen. This study reports early evidence from the development of clinical commissioning groups (CCGs), a key element in the new structures. Aim To explore the development of CCGs in the context of what is known from previous studies of GP involvement in commissioning. Design and setting Case study analysis from sites chosen to provide maximum variety across a number of dimensions, from September 2011 to June 2012. Method A case study analysis was conducted using eight detailed qualitative case studies supplemented by descriptive information from web surveys at two points in time. Data collection involved observation of a variety of meetings, and interviews with key participants. Results Previous research shows that clinical involvement in commissioning is most effective when GPs feel able to act autonomously. Complicated internal structures, alongside developing external accountability relationships mean that CCGs' freedom to act may be subject to considerable constraint. Effective GP engagement is also important in determining outcomes of clinical commissioning, and there are a number of outstanding issues for CCGs, including: who feels 'ownership' of the CCG; how internal communication is conceptualised and realised; and the role and remit of locality groups. Previous incarnations of GP-led commissioning have tended to focus on local and primary care services. CCGs are keen to act to improve quality in their constituent practices, using approaches that many developed under practice-based commissioning. Constrained managerial support and the need to maintain GP engagement may have an impact. Conclusion CCGs are new organisations, faced with significant new responsibilities. This study provides early evidence of issues that CCGs and those responsible for CCG development may wish to address.

Item Type: Article
Keywords: Advisory Committees, organization & administration, Clinical Governance, organization & administration, England, General Practice, organization & administration, standards, Health Care Reform, Humans, Interprofessional Relations, Organizational Case Studies, Primary Health Care, organization & administration, standards, Professional Autonomy, State Medicine, organization & administration, standards
Faculty and Department: Faculty of Public Health and Policy > Dept of Health Services Research and Policy
Faculty of Public Health and Policy > Dept of Global Health and Development
PubMed ID: 23998841
Web of Science ID: 325529200003
URI: http://researchonline.lshtm.ac.uk/id/eprint/1883900

Statistics


Download activity - last 12 months
Downloads since deposit
0Downloads
0Hits
Accesses by country - last 12 months
Accesses by referrer - last 12 months
Impact and interest
Additional statistics for this record are available via IRStats2

Actions (login required)

Edit Item Edit Item