The key AF domains for CCGs are:
- Strong Clinical and Professional Focus
- Meaningful communications with patients, carers and communities
- Clear and credible plans which continue to deliver QIPP challenges within financial resources and in line with national outcome standards and local joint health and well being strategies
- Proper constitutional and governance arrangements
- Collaborative commissioning arrangements with other CCGs and LAs, NCB as well as the appropriate external commissioning support
- Great leaders who individually and collectively can make a difference.
The National Authorisation Framework (AF) for CCG authorisation (Developing clinical commissioning groups: Towards authorisation – Draft) has been produced by the DoH to guide Pathfinder CCGs through to both shadow and full authorisation by April 2012 and April 2013 respectively. The document, Developing The National Commissioning Board (NCB) underlines in principle absolute power to authorise all CCGs with or without conditions to the NCB. No other NHS Body has the power to authorise CCGs.
They are strongly recommended to do this using the AF Diagnostic tool, an interactive xls document that rates position scores, using a sliding scroll and providing a narrative back up for each category scored, into a series of graphical display summaries, An assessment of the key organisational steps to maturity of these organisations can be also be found in the following paper Clinical Commissioning Groups – board progress to shadow status.
Most CCGs will be moving steadily along the track towards authorisation but given the rapid timescale some organisations may be naturally only on the beginning of their journey. Prior CCG assessment has included a series of PCT Cluster managed Organisational Development or OD submissions. Whilst these have been useful they do not always match the protocols exactly of the AF diagnostic toolkit and will have to be transposed into this toolkit prior to submission to the NCB.
Transposing such material to the AF Diagnostic Tool is on the surface relatively straightforward, but as well as placing each domain category scrolls to as the far to the right as they feel possible, CCGs will have to provide written evidence to support the assessment including where appropriate input from the following partner organisations: All GP practices within the CCG; the Local Authority; NHS and Foundation Trusts; patient participation groups; other relevant organisations such as Voluntary and or Charities; the PCT Cluster; and the SHA.
Users of AF Diagnostic Tool both for phase 1 shadow authorisation (April 2012) and phase 2 full authorisation (April 2013) will be required to provide accurate and detailed written evidence in their submission to the NCB to back it up.
There are currently 255 CCGs although it is anticipated that this number is currently to reduce to less than 175 through a number of mergers. This policy is not new and has been articulated for some time by both the SoS and the DoH and is reflective of the direction of the new Commissioning Architecture NHS rationalisation.
None of the above will be easy to achieve with or without boundary changes and some CCGs members may think they are being pushed too far too fast to be able to submit their individual and collective submissions by the end of 2011.
Health Solutions Partnership has both a set of core CCG development products as well as additional support products that can address all of the above domains and support CCGs through this process.