A draft of A Framework for Collaborative Commissioning between CCGs was published by the NHSCB last Friday. The guidance highlights the benefits of and options for CCGs collaborating to share contracts with providers and risk sharing.
We know this guidance has been eagerly awaited by many CCGs. It sets out the legal requirements for collaborative commissioning across CCGs and the specific factors that need to be considered when two or more CCGs are commissioning services from the same provider.
You'll be aware that CCGs are required to have considered collaborative working as part of the national CCG authorisation process.
The guidance says arrangements must be in place by October 'in time for the start of the 2013-14 contracting round'. It sets out a range of collaborative models at appendix 2 which CCGs can choose from.
Determining which services and contracts to collaborate on will be key for CCGs. The guidance says CCGs must determine which other CCGs they will collaborate with in which instances and agree with the other CCGs in the collaborative the approach they will take the model they will use and what each CCG will contribute. To help with these decisions a database has been provided in appendix 1 which enables users to view the main providers for a CCG and the main commissioning CCGs for a provider.
CCGs must also 'determine what if any additional support might be needed for example from a [commissioning support service] and determine how this will be funded' and 'design agree and implement the governance arrangements that enable the collaboration and ensure these arrangements are reflected in their constitution plans and structure'.
The guidance suggests different approaches: Where two or more CCGs commission a single service they could work together to ensure consistency in quality for their patients. In some cases a large number of CCGs might commission a single service that is organised across a large geographical area (such as ambulance services) and in other cases a group of CCGs who are geographical neighbours may wish to work together on a contract with a single provider to which the majority of their patients flow.
There is no suggestion that CCGs will be required to create a funding risk pool to help groups which overspend either with other CCGs or with the commissioning board. However it says: The CCGs may wish to consider whether they will share or pool risks particularly in respect of financial and activity deviance and agree how this will be managed.