The NHS Commissioning Board Authority has recently published in draft "A framework for collaborative commissioning between clinical commissioning groups" acknowledging that no CCG is an island and CCGs will often have to work collaboratively with other CCGs and with other organisations and will need to look beyond their own local commissioning role to ensure quality access and outcomes requirements are met - so much for the extreme localism promulgated by the Secretary of State when the NHS reforms began!
The current draft guidance is limited in scope to intra-CCG collaborations but reassures us that further guidance will be provided in due course (oh good!) to address collaborations with other organisations such as local authorities to cover joint and integrated commissioning arrangements.
A 'Model Collaborative Agreement' is also promised in September but at Mills & Reeve we have been receiving instructions to advise CCGs on proposed collaboration agreements since early in the current NHS year.
The amended NHS Act 2006 will give CCGs the legal power to collaborate with other CCGs. However regardless of any collaboration arrangements which may be made using that power each CCG remains accountable for commissioning services that meet the needs of its population and for ensuring that all relevant quality standards are met. So there is no passing the buck to another CCG or a CSU by entering into collaborative commissioning arrangements.
Delegated arrangements for the exercise of a CCG function must be set out in the constitution of the CCG which is why the arrangements that will be put in place need to be thought about now before the constitutions are finalised and the CCG is authorised.
Technical appendix 2 to the guidance describes a number of different possible structures that could be adopted to underpin the arrangements involving combinations of CCGs and providers as well as support from a CSU. Whatever arrangements the CCGs decide to make these will need to be reflected in all their constitutions.
CCGs are required to have met their authorisation requirements by the end of October 2012 in time for the start of the 2013/14 contracting round and to ensure that new arrangements can be put in place by the time CCGs assume their functions as statutory bodies.