NHS scrutiny: ‘Why does Norfolk need FIVE clinical commissioning groups’
- Credit: PA
They are a small group of people with hundreds of millions of pounds at their disposal and they hold the power over your healthcare.
But now questions are being asked about the way clinical commissioning groups (CCGs) operate and the impact their choices have on patients.
Alex Stewart, chairman of Healthwatch Norfolk, an independent patient organisation with statutory powers, said CCGs in Norfolk and Waveney have to become more 'entwined' or else he fears they will implode.
Healthcare in our area is commissioned on patients' behalf by five such CCGs: Norwich CCG, South Norfolk CCG, North Norfolk CCG, West Norfolk CCG, and Great Yarmouth and Waveney CCG.
Each CCG is made up of GP practices in each area which meet to plan and design local services, and then buy those health and care services for patients.
Those services include emergency and non-emergency medical treatment, rehabilitation, community health and mental health services.
In other words, whether the care you receive is from a hospital, GP, mental health team, paramedic, or district nurse, it is paid for by your CCG. But while there are five CCGs in Norfolk and Waveney, there are only two in Suffolk and one in Cambridgeshire.
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'I have never understood why Norfolk has five CCGs,' Mr Stewart said.
'CCGs are talking about making cuts to save money yet each CCG has a set of chief executives, chief operating officers, and finances officers, some of whom earn more than £100,000.
'The CCGs are still very much working within their own budget-setting, which they have to do, but it makes you wonder if they merged their budgets then back-office costs could be reduced.'
During the redesign of the NHS under the 2012 Health and Social Care Act, when CCGs replaced Primary Care Trusts, GP practices were asked to form groups which they felt best represented their localities and would therefore best represent patients, prompting the birth of Norfolk's five CCGs.
Mr Stewart said he feared the 'postcode lottery' effect as CCGs are increasingly having to make financial savings, which means patients in one area may not be eligible for certain NHS services that remain available in other parts of the county.
But Lord David Prior, minister for NHS productivity whose remit includes CCG allocations, said there would always be some variations within the NHS but added he expected CCGs to work together when deciding their commissioning policy.
'The government has made it clear that the last thing the NHS needs is a re-organisation,' he said.
'We think it is better to devolve the decision-making to GPs on the grounds that they know their area best.'