The HSJ's 'barometer' survey of CCG leaders asked them to rate potential barriers to their effectiveness as an organisation in the next year. The survey found almost all think greater integration of services will improve quality while half think competition and AQP will do the same.
116 CCG leaders from 101 organisations responded to the survey. Sixty-five per cent were GPs. Forty-seven per cent were CCG chairs thirty eight per cent were accountable officers and the remaining fifteen per cent were other senior executives or governing body members.
Asked to rate a set of possible service improvement methods 96 per cent of responding CCG leaders said they were likely to encourage increased integration of their existing providers in the next year. A significant but smaller proportion (50 per cent) said they were likely to make greater use of alternative providers and increased competition.
Asked to rate a series of potential impediments to their ability to improve services 73 per cent replied - requirements to introduce more competition and competitive procurement; 82 per cent the NHS 'per treatment tariff system'; and just 23 per cent - not enough opportunity to introduce competition and new providers.
Rating potential steps for improving their effectiveness as a commissioner 84 per cent said they would increase shared commissioning functions or pool budgets with a local authority.
Asked to rate confidence in their organisation's effectiveness the result was 7.9/10. By contrast in a recent HSJ barometer of hospital chief executives rating commissioner's effectiveness the result was just 3.1/10.
More than one in four reported they are likely to try to close or downgrade an A&E unit in the next year. Nearly nine in ten CCG leaders said they were likely to introduce bans or limits on some treatments.
The most widely quoted barriers to effectiveness as organisations from April 2013 were the national ?25 per head limit on administration costs followed by having a weak CSU. Yet few CCGs seem set to abandon their unit: just 20 per cent thought it likely and 6 per cent very likely that their CCG might move a significant amount of commissioning support in-house in the next year. Interestingly 19 per cent said they were likely to tender a significant amount of their support to alternative providers.