NHS Clinical Commissioning Groups (CCGs) were created as a replacement for Primary Healthcare Trusts in 2013 and are responsible for designing local health services in England. The commissioners who lead the groups are GPs and other clinicians that work in the local area.
CCGs aim to get the best possible health outcomes for the local population. Sadly the current reality of CCGs is that they are so cash-strapped that they often have to make difficult and controversial decisions about patients’ access to treatment. One CCG recently announced they would be postponing non-urgent surgery for over 100 days to push it into next financial year. Last year a survey of CCG representatives showed that only 21% felt their CCG had the financial resources it needs to deliver the services that local patients expect. CCGs are not only expected to manage with such limited funding, but to also come up with new ideas of ways of working.
So how can charities help?
Charities are well placed to advise what health and social care services are needed in local communities and to suggest new ways of working.
nfpSynergy’s Primary Healthcare Monitor is an annual a survey of 250 GPs and nurses, including 75 GPs who have a role on a Clinical Commissioning Group. Last June we asked commissioners what role charities should play in their local area to support the integration of health and social care services. Several GPs with a commissioning role expressed a desire for charities to promote themselves to CCGs as available to help with service design, as they have knowledge of what’s needed in local communities:
- “Should help in service design and give input re needs of local community”
- “Advice on key needs of community and the resources required.”
- “Be proactive, come to talk and contribute to commissioners and others. Demonstrate a true knowledge of the challenges felt at the coal face - not just see themselves as a distant adjunct.”
Here are five tips for charities to make a success of working in partnership with CCGs:
1. Find ways to engage with CCGs without increasing their workload
Last year a GP with a commissioning role told us “I find involvement of charities increases workload, which I have not got capacity for.” It is important for charities to be seen to support CCGs, rather than create extra work at a time they already feel over-stretched. This could involve working more in coalition with other charities in your field to reduce duplication of work.
2. Engage with MPs who see charity involvement in redesigning health and social care services as privatisation of the NHS
In the Charity Parliamentary Monitor in January 2016 we asked MPs about their views on partnerships between charities and the NHS. 86% of Conservative MPs said that they would support the NHS partnering with the third sector to reform/redesign services, compared to only 53% of Labour MPs. When we asked for their comments, some Labour MPs voiced concerns of the “danger of further fragmentation and complexity and lack of accountability” in the NHS and said that they are “opposed to outside organisations redesigning services.” Most Labour MPs said that in theory they support charities working in partnership with the NHS, but that the “devil is in the detail”. Speak to MPs to set out what you are trying to achieve for your beneficiaries in their constituencies.
3. Communicate your evidence base and outcomes clearly to more sceptical healthcare professionals, who may also have concerns about privatisation of the NHS
As with MPs, some healthcare professionals are wary that charity partnerships with CCGs mean that the Government and NHS are taking less responsibility. In our research with healthcare professionals, several GPs expressed dismay that charities would be filling in services they felt the NHS should provide:
- “[Charities should support with] Non vital services, they end up providing vital stuff that should be NHS.” – GP
- “Charities should not be expected to fill NHS / social care gaps - unless funded to do so by NHS/social care budgets.” – GP
Be clear to CCGs why you feel your charity has a role to play (based on your expertise and connections to local communities), and also be ready to speak up and campaign when you believe the Government and NHS need to take more responsibility.
4. Don’t be afraid to speak out when commissioning services at the local level is not working
A few weeks ago the British Medical Journal released research showing that there is inconsistent provision of end-of-life care across Clinical Commissioning Groups. End-of-life care is considered as a universal right so provision needs to be decided on at a national level to avoid it becoming a ‘postcode lottery’. This will also be the case for other aspects of health and social care.
5. Remember that Clinical Commissioning Groups only operate in England
Finally, bear in mind that CCGs do not exist in Scotland, Northern Ireland and Wales. They all have their own geographically-based health boards/trusts, set up with a similar aim of providing health services based on the needs of the local community. Consider any differences in the responsibilities of each country’s health boards.
If you're interested in learning more about our research with healthcare professionals, please download the Primary Healthcare Monitor briefing pack using the purple download form below, or contact Fiona Wallace at firstname.lastname@example.org
You can also share your thoughts on this topic in the comments section, located beneath the purple download form.