Learn the lingo series: "CCG: Clinical Commissioning Groups"

Written by Jyothis George on 30 September 2012. Modified on 01 January 2013. Hits: 8650

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Clinical Commissioning Groups (CCGs) are clusters of GP practices that will be responsible for commissioning the majority of healthcare in England from April 2013. The 212 CCGs, consisting of 8,355 GP practices across England, will have similar responsibilities to PCTs, although commissioning of public health, specialised and primary care services will sit with the Local Authority and the NHS Commissioning Board (NHSCB).

CCGs’ responsibilities include:

  •  Urgent and emergency care including A&E, ambulance and out- of-hours services;
  • Community health services;
  • Maternity services; and
  • Elective hospital care.

The CCG lead must be a GP, however, the CCG Board will consist of a secondary care specialist, a nurse and at least three lay members. There will also be an Accountable Officer, who can come from any field, clinical or non- clinical. The population size that each CCG covers ranges from 68,000 patients to 901,000 patients.


The proposal to put GPs in charge of the majority of commissioning in England was first proposed in a Government White Paper in July 2010. The original proposal was to create ‘GP-led consortia’ out of clusters of GP practices and hand these consortia a large portion of the NHS commissioning budget. The Government believed this would mean decisions were more likely to be made on clinical grounds. They also felt that by putting those closest to patients in charge of the budget, patient experience would improve. They felt this was a natural progression from earlier policies such as GP fund-holding and practice- based commissioning.

In March 2011, the Government made a series of concessions in an attempt to calm some of the concerns surrounding the reforms. One of the concessions was to involve other healthcare professionals in commissioning. This resulted in GP consortia being renamed CCGs and the mandatory involvement of other healthcare professionals on each CCG board.


In order to assume their commissioning responsibilities from April 2013, CCGs will have to successfully pass the authorisation process run by the NHSCB. This process will establish whether an individual CCG is financially and structurally able to fulfil its commissioning duties. The authorisation process has four application waves and the whole process will be completed by January 2013, four months before CCGs start commissioning. The first wave consists of 35 CCGs and should be completed by November 2012. This will be followed by 70 CCGs in wave 2, 66 in wave three, and 41 in wave four. Once the process is complete CCGs will be in one of three states:

  • Authorised - will assume commissioning responsibility immediately.
  • Authorised with conditions - will jointly commission services with the NHSCB.
  • Established but not authorised - are legally established but as they are not ready to take on commissioning, the NHSCB will commission on their behalf until the CCG passes the authorisation process.

To ensure CCGs are commissioning effectively, they will publish an annual report on their financial status and their performance against indicators included in the Commissioning Outcomes Framework (COF). CCGs will also have to work with their Local Authority and Health & Wellbeing Boards to ensure their commissioning plans reflect the needs of the local population. This will be assessed through the Joint Strategic Needs Assessment (JSNA), which is developed by Health & W ellbeing Boards. If an individual CCG’s commissioning plan does not sufficiently meet the JSNA, Health & Wellbeing Boards have the power to report a CCG to the NHSCB.

To assist with the administration and management costs, each CCG will be apportioned an annual running cost allowance of £25 per patient. In addition, CCGs will receive support from external Commissioning Support Units (CSUs). There are expected to be 23 CSUs, which will be hosted by the NHSCB at arm’s length.

Editor's note: This article has been generated from information provided by Sanofi Diabetes. Please also note that the article is not regularly monitored and may become less accurate over time as things evolve. Please see this section for the latest news on NHS, reforms etc.

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