CCGs should be the same size as current PCT clusters and cover around one million patients to avoid being treated “like children”.
Dr Richard Vautrey, Deputy Chair of the BMA’s GP Committee, told MiP that government guidance on commissioning support means ‘bigger is better’ for CCGs.
In a statement last week, the BMA claimed the introduction of commercially-focused criteria to determine eligibility for providing commissioning support will make it “almost impossible for CCGs to have their own, in-house support staff”.
Dr Vautrey claimed small CCGs are in danger of “dancing to the tune of external commissioners” in the future.
“CCGs should be brave enough to challenge what the DH and PCT clusters say and create the structures that suit themselves,” he said.
Despite not wanting “a replication of the old PCT structure”, Dr Vautrey told MiP CCGs should be the same size as current PCT clusters in order for them to hold some “clout”.
Dr Shane Gordon, Chief Executive of NE Essex Clinical Commissioning Group, criticised the BMA for “playing up to the fear” of competition in its interpretation of the DH’s draft guidance of Commissioning Support Units (CSUs).
Dr Gordon told MiP the reverse of the BMA’s fears is actually true – CCG leads are not being given the freedom to look outside of their own PCT cluster for commissioning support.
“It feels like we are being told we are too stupid to choose,” he said.
“The reforms peddle the message ‘no decision about me without me’ for our patients, so why isn’t that message the same for us as intelligent customers?”
Speaking at the NHS Alliance’s annual conference in Manchester yesterday (30 November), Dr Gordon told CCG leads to start “making noise” about CSU choice now if they don’t want to end up with the “same system as before”.
Sir David Nicholson, Chief Executive of the NHS, admitted CCGs should be able to choose between PCT clusters for commissioning support and said he is “very keen” to look into “how that can work”.