The sands are shifting - but in which direction?

Last month we learnt that notwithstanding that statutory functions remain with SHAs and PCTs until April 2013, 'operational responsibility' would be stripped from PCT and SHA leaders from 1 October 2012.

We now learn also that the deadlines for CCG authorisation have been moved back one month so even the first wave CCGs will not be authorised until November (rather than October as previously envisaged). All subsequent waves have been similarly delayed by one month so that the fourth wave will not be authorised now until February 2013.

So where will 'operational responsibility' sit on 1 October? The uncomfortable answer appears to be that at best it is sitting with CCGs (which have no separate legal status of their own) operating as committees of PCTs whose executive and management team no longer has any 'operational responsibility'. The worst case scenario could be that 'operational responsibility' now sits with an as yet unauthorised body that may never acquire legal status.

Legally of course the plethora of functions carried out by SHAs and PCTs must remain the responsibility of those statutory bodies until April 2013. However this gives rise to further cause for concern as the skeletal management structures remaining in many such organisations remain accountable for making all the decisions necessary to keep the NHS going.

It is now also clear that the initial expectation that CCGs would not inherit the debts and liabilities of their statutory predecessors has been ousted to folk-law! Of course the debts and other liabilities of PCTs must be inherited by a successor body of some kind if not the CCGs. It was thought by many that the NCB would step up but it now seems that in all likelihood the bodies already in reality making the relevant decisions and holding the purse strings will be the ones receiving the relevant liabilities and statutory functions in the future and they will be anxious to minimise their negative legacy.

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