'Steering or Rowing? Report from a simulation event which tested how CCGs might utilise CSSs' outlines the challenges and areas of support these organisations need to consider when working together.
The report has been jointly-produced by NHSCC and the University of Birmingham’s Health Services Management Centre. It highlights the learning from a scenario workshop held in May 2012, which was designed to explore the relationship between Clinical Commissioning Groups (CCGs) and Commissioning Support Services (CSSs).
As CCGs move on to full authorisation, they will need all the support they can get. NHSCC has published this report to help CCG leaders think through how they can make best use of their own clinical strengths and expertise, while drawing on the resources available from CSSs to commission the best services possible for their local community.
The report identifies seven key themes and respective learning points:
- Relationship development;
- Leadership and authority;
- Customer/supplier models;
- Using clinical expertise;
- Learning from others; Rule of rescue or business acumen, and:
- Governance mandate.
These themes and lessons will be used to inform the NHS Commissioning Board Authority and other partners on their approach to commissioning support development over the coming months.
Key learning points from the report are:
- CCGs need to understand the range of options available to them both locally and nationally. CSSs need to market their services in ways that are meaningful to CCGs to enable them to make informed choices about where and what support they will access.
- Whilst CCGs and CSSs wish to maximise the benefits of clinically-led commissioning, they also need to understand when clinical involvement is essential and when other members of the commissioning team are better positioned to take over certain parts of the process.
- The role of the wider clinical team in offering expert advice and support to the commissioning process needs to be embraced (including nurses, allied health professionals and acute trust clinicians).
- CCGs and CSSs need to be aware about which services are available and needed. They need to invest time in expanding their networks and in understanding the roles and responsibilities of other players.
The customer/supplier relationship, between CCGs and CSSs, needs to be explored and tested in practice, until an acceptable balance is achieved.
CSSs need to maximise the potential for joint working without impairing accountability.
Dr Charles Alessi, Interim Chairman, NHSCC said:
“This is a critical issue for CCGs and CSSs. It is of fundamental importance that CCGs are fully aware locally of their specific needs before deciding upon any commissioning support arrangements. It is of equal importance that they are alert to all the consequential implications of the decisions they are taking. These should be explored and discussed with available legal support.
“This is also about a cultural change, with clinicians, including nurses and other professionals and with advice from local management expertise, determining their requirements. No longer do clinical commissioners have to submit to central imposition. However, it is of equal importance that all parties maintain constructive relationships.”
Julie Wood, Interim Commissioning Development Director, NHSCC, said:
“It is absolutely crucial that clinical commissioners receive the support they need to create a robust strategy for their work with commissioning support services. Not only do CCGs need a lot more clarity on the options available to them in terms of using CSSs, but they also need to be able to access a range of practical support which is relevant to their requirements.
“CCGs are at different stages of their journey to authorisation and of taking on their strategic role as commissioners. NHSCC will continue to work with and support CCGs in becoming informed customers of commissioning support services and shaping the future of clinically-led commissioning.”
Dame Barbara Hakin, National Director of Commissioning Development, said:
“CCGs and Commissioning Support Units (CSUs) are developing in tandem, and thanks to their hard work they are on track to meet key milestones in the establishment of the new clinical commissioning system. There is still a great deal of work to do to ensure that clinical commissioners have all the support they need and we have used the insights from this report to inform the next phase of the NHS Commissioning Board Authority’s programme of practical, targeted CCG and CSU development support over the coming months."