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Every GP practice will need to join a Clinical Commissioning Group. Legislation will be passed to establish these groups as statutory bodies. However, not all GPs, practice nurses and managers will have to be actively involved in every aspect of commissioning.

Whatever role GPs, nurses and managers intend to play in the new commissioning landscape it will be important to join a Clinical Commissioning Group as soon as possible, not least because the new National Commissioning Board (NCB) will assign practices to groups if necessary.

The timetable for Clinical Commissioning Groups

2010/11 - GP consortia, now rebranded as Clinical Commissioning Groups (CCG), begin to form on a shadow basis, building on Practice based Commissioning (PbC) groups where appropriate.

2011/12 - All CCG to be established in shadow form, supported by the NCB.

2012/13 - Formal establishment of CCG on a statutory basis, with indicative allocations made to the groups.

April 2013 - PCTs cease to exist and CCG become fully operational, holding real budgets and contracts with providers.

The timetable starts now and GPs need to start considering which CCG they will join. Issues to consider include: 

• What will be the size and geographic focus of your group? GPs need to bear in mind that CCG will need to be of sufficient size and geographic reach to manage financial risk effectively.
• Which commissioning activities will the group undertake itself and which will require collaboration with other CCG under a ‘lead commissioner’ model?
• Which commissioning tasks will the group undertake itself and which tasks will it buy in support for using its management allowance?
• Which GPs or practices will manage the CCG and what role will other member practices play?
• How will member practices be held to account to ensure that income linked to outcomes is not jeopardised?
• How will the group ensure transparency and the promotion of choice in commissioning decision-making?
• What will the internal governance arrangements of the CCG look like?
• How will the CCG manage financial and service risks?
• Who will be the Accountable Officer and the Chief Financial Officer?

How we can help GPs form and manage Clinical Commission Groups

Shadow consortia – the legal form of shadow consortia and building on existing PbC arrangements

Governance arrangements – internal governance arrangements for consortia including criteria for membership and arrangements with member practices

Corporate governance – compliance with the duties of public bodies including procurement law, public and patient involvement duties and equalities legislation

Contracting – contracting arrangements with the NCB and providers

Contestability and competition – how to shape a market including by using the Any Willing Provider model

Buying in management support – contractual arrangements to buy in management support from PCTs, local authorities, GPs and independent/voluntary sector providers

Managing conflicts of interest – mitigating the risks of challenge by making transparent commissioning decisions and avoiding conflicts of interest