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17 December 2018

Over a third of local healthcare providers overspent last year, says NAO

Clinical Commissioning Groups exceeded their budgets by £213m in 2017-18.

By Rohan Banerjee

Many Clinical Commissioning Groups (CCGs) have struggled to operate within budget, and to hire the high-quality staff they need, according to a report by the National Audit Office (NAO).

More than a third of CCGs – 75 out of 207 nationwide – overspent against their total budget plan. In 2017-18, there was an overspend of £213m across all CCGs.

CCGs were established by the government’s Health and Social Care Act in 2012. They are NHS-run bodies, made up of GP practices, pharmacies, opticians and other amenities, responsible for the delivery of treatments and services within a set area.

The structure of CCGs is changing. Eight have merged since 2013 and 117 share senior management teams. Most CCGs now share accounting officers, according to the NAO, and some have established joint commissioning arrangements with their local authority. This trend is expected to continue which will probably result in fewer CCGs covering larger populations.

Bigger CCGs may help to simplify planning processes and to integrate a wider range of services, but there is a risk that managing greater numbers of patients will make it more difficult for CCGs to create local health services that are responsive to individual needs.

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The NAO report said that the overstretching of resources has led many CCGs to struggling to recruit staff, with 46 per cent experiencing difficulties in hiring for senior positions due to the increased pressure of responsibilities, the uncertain future of individual CCGs, and a lack of access to training and development.

NHS England was due to outline a long-term plan for the NHS this month, in which it was expected to establish criteria for interventions when CCGs do not perform to the plan’s new standards. But the publication of that document has now been delayed until at least January 2019.

Amyas Morse, the NAO’s Comptroller & Auditor General, said of the organisation’s report: “It would be a huge waste if in five years’ time NHS commissioning is undergoing yet another cycle of reorganisation resulting in significant upheaval. The current restructuring of CCGs must deliver balance and effective organisations that can support the long-term aims of the NHS and deliver a much-needed prolonged period of stability.”