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Commissioning Healthcare in EnglandEvidence, Policy and Practice$
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Pauline Allen, Kath Checkland, Valerie Moran, and Stephen Peckham

Print publication date: 2020

Print ISBN-13: 9781447346111

Published to Policy Press Scholarship Online: September 2020

DOI: 10.1332/policypress/9781447346111.001.0001

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The development and early operation of Clinical Commissioning Groups (CCGs)

The development and early operation of Clinical Commissioning Groups (CCGs)

(p.35) 3 The development and early operation of Clinical Commissioning Groups (CCGs)
Commissioning Healthcare in England

Anna Coleman

Imelda McDermott

Lynsey Warwick-Giles

Kath Checkland

Policy Press

Chapter 3 deals with the development and early operation of Clinical Commissioning Groups (CCGs) of GPs. Building upon the context set out in chapter 2, we examine the factors affecting early CCG development, highlighting the complexity of their governance structures, approaches taken to engaging with their members and the development of external relationships with a wide range of new bodies. We found an explicitly ‘bottom up’ approach to policy implementation, with CCGs given considerable lee-way in developing their structures and processes. As a result, the history of previous commissioning structures and arrangements played an important role in the development of each CCG, as did the approach taken by local leaders and by the PCT/ developing NHS England local team. Engagement with local bodies such as Health and Wellbeing Boards and Local Authorities were also significantly affected by local history and geography. We found that the approach taken by NHS England to CCG development, with early freedom to develop as they chose increasingly curtailed by more prescriptive guidance and a complex assurance regime, led to some frustrations for those involved.

Keywords:   CCGs, Clinical involvement, Commissioning, GPs

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