To pool or not to pool: that is the question?

The NHS CBA's draft "Framework for Collaborative Commissioning between Clinical Commissioning Groups" (new framework) acknowledged that CCGs will not be able to operate in isolation and will often have to work collaboratively both with other CCGs and with other organisations to ensure quality access and outcomes requirements are met.

The framework promised further guidance in relation to collaborations with non-CCG organisations such as local authorities where CCGs will need to collaborate on joint and integrated commissioning arrangements.

It seems this guidance is now beginning to trickle through in an unexpected manner. It has been reported that the Government may use its forthcoming Care And Support Bill to force CCGs to go as far as to share some of their budget with local authorities as part of their involvement in a joint planning process with the local authority specifically to create a pooled budget for care and support for people with long-term needs. We are awaiting further details.

While giving evidence to the House of Commons Public Accounts Committee NHS and NHSCB chief executive Sir David Nicholson said that to be authorised CCGs will need to show they have financial risk-sharing arrangements in place with their neighbours and must demonstrate the collaborative arrangements they have in place and how they propose to risk share with other CCGs in the area.

However in contrast to all Sir David Nicholson also warned that too many organisations in the new NHS seeking to risk-pool funds could lead to serious problems. He explained how the NHSCB was working to ensure that CCGs risk-pooling with other organisations when combined with actions taken by Monitor and the DH involving the holding back of funding will not result in organisations being pushed towards financial failure.

It seems that CCGs need to tread a fine line.

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