Primary Care Co-Commissioning Presentation for CCG Board 15th January 2015 Next steps towards primary care cocommissioning – Three options • Greater involvement for CCGs in primary care decision-making; NHS England retain responsibility for all commissioning decisions • Joint commissioning arrangements where CCGs and NHS England assume joint responsibility for an agreed set of functions, potentially under a joint committee with pooled funding arrangements • Delegated commissioning arrangements where CCGs assume full responsibility for commissioning all the functions of general practice services, although legally NHS England will retain residual liability so will require robust assurance that statutory functions are discharged effectively. National perspective - Co-commissioning of primary care • GP services only (other areas for 2016/17 will be considered) • Performance issues/admin payments and list management excluded • Supports “placed based commissioning” • Creates new opportunities e.g. locally based QOF Our rationale for co-commissioning • Alignment of 5 year Strategy with primary care • Maximising opportunities for aligning incentives • Clinical leadership and public engagement around primary care commissioning • CCGs have increased responsibilities for primary care commissioning in 2015/16 Current arrangements • Joint Primary Care Commissioning Group – Workforce, Estates, Budgets, Local Opportunity Fund • Primary Care Work Plan • Next Priority – to develop a Primary Care Strategy What does joint commissioning mean in practice?  Formalise our commissioning relationship with NHSE - A framework is to be developed setting out details of the joint arrangements  Provides greater ability to influence primary care than current position  Could include a pooled funding arrangement for investment in primary care services  Provides platform for moving to delegated arrangements in future in a staged way Governance Requirements • CCG Constitution to be amended to allow joint commissioning arrangements with NHSE for the exercise of NHSE functions: – establishment of a Joint Committee (of the Board) to exercise primary care co-commissioning functions – membership must have a lay and executive member majority – This committee should meet in public and have representatives from HWB and Healthwatch (not members) Consultation and Timelines • The membership of the CCG must be consulted and agree any changes to the role of the CCG as detailed in the constitution • Build on previous engagement with practices, LMC and other stakeholders to the support the board decision in June 2014 regarding primary co-commissioning Next Steps • Submission deadline to NHSE 30th January • GP Forum in February will provide an opportunity to consult regarding the cocommissioning proposals and secure agreement to the constitutional changes • The new arrangements would come in place 1st April 2015.