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CASE STUDY

Gaining Authorisation

for

Haringey Clinical Commissioning Group

Haringey CCG

Background

Clinical Commissioning Groups (CCGs) were created following the re-organisation of NHS services delivery under the Health and Social Care Act 2012.  The clinically-led groups aim to give GPs and other clinicians the power to influence the way local services are provided by giving them control of the NHS budget.  This enables the frontline to plan and commission hospital, community health and mental health services, improving and personalising healthcare.

ON MONDAY 1ST APRIL 2013 ……

………. “Some organisations such as primary care trusts (PCTs) and strategic health authorities (SHAs) will be abolished, and other new organisations, such as clinical commissioning groups (CCGs), will take their place.”

(Health and Social Care Act 2012)

Challenge

The Consultancy Company was appointed to support Haringey Shadow Clinical Commissioning Group in gaining authorisation as a CCG by 1st April 2013.   Haringey wanted to undertake the majority of the work internally, but recognised the need for additional specialist support from a partner who fully understood the PCT to CCG transition policy requirements and implications.

The first steps were to ascertain and understand the relevant DH and NHSE policy guidance, authorisation process.  The broad range of criteria to be fulfilled was crucial.  Haringey needed to demonstrate a thorough understanding of the framework, redesign organisational structures and process to match CCG requirements and demonstrate competencies within a series of deadlines.

As Sarah Price, Chief Officer, from Haringey CCG explains, “The whole process was evolving, dynamic and often unclear, with emerging policy guidance, deadlines and milestones. It was vital to have a good Project Director in place to help take us through the requisite stages.”

The Solution

Our consultants kick-started the process by establishing a Programme Management Office with clinical/managerial teams in place to address the 119 criteria within the six domain work streams as set out in the CCG authorisation framework:

  • A strong clinical and multi-professional focus which brings real added value
  • Meaningful engagement with patients, carers and their communities
  • Clear and credible plans to continue to deliver the NHS’ Quality Innovation Productivity and Prevention initiative (QIPP) within financial resources, in line with national requirements (including outcomes) and local joint health and wellbeing strategies
  • Proper constitutional and governance arrangements, with the capacity and capability to deliver all their duties and responsibilities, including financial control, as well as effectively commission all the services within their remit
  • Sharing arrangements for commissioning with other CCGs, local authorities and the NHS England Commissioning Board as well as the appropriate external commissioning support (CSU)
  • Great leaders who individually and collectively can make a real difference.

The authorisation process comprised three distinct phases: pre-application, application and finally NHS England assessment.  Key here was working within a pre-defined stakeholder engagement process, requiring sensitive local management.  Haringey also had to develop close working relationships with the emerging local Commissioning Support Unit (CSU) and to ensure that respective CCG/CSU processes and accountabilities were clearly defined, fully compatible and understood.

Haringey’s strategy was to be part of Wave 3 out of four authorisation waves, enabling them to take learnings from Wave 1 and Wave 2 applicants while being on track for CCG status by the end of March 2013.

By its third assessment round in February 2013, Haringey had increased the approved criteria from 57 in October to 116 – with just 3 non-compliances to be resolved, achieving full authorisation in March.  The Consultancy Company had been key to understanding how the CCG was being evaluated, challenging appropriately to ensure that Haringey’s case was heard and treated on the basis of the evidence submitted.

The Benefits

Haringey CCG became a statutory organisation in April 2013 and took over the planning, monitoring and buying of services for local people in Haringey.  A strong and effective commissioning organisation, comprising 50 GP practices, Haringey CCG has created a sustainable health community that puts patients first, giving clinicians the autonomy to tailor key healthcare decisions to their specific needs.

Sarah Price comments, “Our vision is to enable the people of Haringey to live long and healthy lives with access to safe, well co-ordinated and high quality services.  The creation of the CCG was a complex process that required a real understanding of the impact of this major change within the NHS.  With The Consultancy Company’s expertise we were able to navigate this successfully achieving our full CCG status within our timeframe.”

 

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