Discussion roundup: Clinical commissioning groups

The debate explored whether GPs are able to balance their workloads with new managerial duties. Photograph: Martin Godwin for the Guardian

Mark Wilkinson, chief officer, NHS Barnsley CCG: "We have to look at how we can fully utilise the CSU. I'm challenging my team to explore CSU options rather than simply recreating our own in-house capacity."

Phil Mettam, chief officer, NHS Bassetlaw CCG: "We have developed a way of working where staff have supported autonomy, clinicians are predominantly involved in service conversations (not governance), and everyone is encouraged to be pragmatic and flexible."

Jonathan Sheffield, chief executive, the National Institute for Health Research Clinical Research Network: "In some parts of the country, barriers to research have really been broken down by the determination of CCG's to make sure excess treatment costs related to research are being covered. But in other areas, because the guidance has yet to be revised by the National Commissioning Board, there has been some rejection of requests for excess treatment costs. We also have some instances of new qualified providers being unsure, and even sometimes unwilling, to support research in their clinical area."

Mark Wilkinson: "I'm not sure the actual barriers have changed as a consequence of reconfiguration. What I suspect has happened, although this will be highly variable across the country, is that attention (at least in the transition from PCTs to CCGs) has been focused elsewhere on setup, building new relationships, bedding in new governance arrangements etc."

Chris Naylor, fellow, King's Fund: "I think there's a general spirit of wanting to support learning and sharing of best practice – the barrier, though, is time, which for most people working in CCGs over the last year has been in very short supply."

Jonathon Fagge, chief executive, NHS Norwich CCG: "Last year we commissioned Equal Lives to develop a co-production model for us. The first project will be community mental health services. Equal Lives will recruit and support a community involvement panel of service users and community representatives. We will jointly develop the service description, manage a wider public consultation, co-produce the service specification, and then involve the panel in bid evaluation."

Mark Wilkinson: "At Barnsley CCG we are determined to become an example for patient and public engagement. Quite how we move from aspiration to delivery requires quite a shift. And I do think this is an area where CCGs could do with some help."

Jonathan Sheffield: "The NIHR Mental Health Research Network team have strong links to patient groups and we involve patients in the design of questions to be answered through research, as well as specifically using patients to review protocols prior to implementation of studies."

Victoria Bleazard, associate director of policy, research and campaigns, Rethink Mental Illness: "We often hear of people being consulted by local authorities and different bits of the NHS at the same time on pretty much the same questions. Some models are being developed to try and join up engagement across agencies so that there are more resources to do it better and properly understand local need."

Phil Mettam: "We try and engage on a themed basis ... We hold an annual Big Health day where we invite people with a learning disability and their carers to tell us what they think about how the NHS, LA, and voluntary sector is supporting them and looking after them."

Robert McGough, partner in DAC Beachcroft's health commercial team: "There are a variety of approaches to member engagement as the governance structures have been set up in varying ways – some have more centralised structures with more control in the governing bodies, others delegate to localities to get local practice engagement."

Jonathon Fagge: "Provided CCGs focus on improvement rather than assurance I believe we can be a catalyst for improvement in the quality of primary care, and maintain good relationships with our members."

Chris Naylor: "One concern I've heard raised is about NHS England having limited capacity to perform performance management responsibilities. Some CCGs seem to be anxious that they will be sucked into that role in spite of their intentions to strike a supportive relationship with members."

Michael Scott, chair of the NHS Confederation's Community Health Services Forum: "Our early experience as a provider is that we find that there could be stronger links, ie what we are asked contractually to deliver by the CCG can be at odds with individual practice priorities and vice versa."

Chris Naylor: "The financial environment is obviously a big challenge. To that I'd add the challenge of engaging local GPs and demonstrating to them that CCGs can bring about improvements for GPs and their patients."

Robert McGough: "I would add the challenge of understanding their "inheritance" from the PCT – what the legacy contractual and structural issues are, what has actually transferred to the CCG, and what else may be delegated from NHS England, as well as how they engage with effective commissioning support services."

Richard Vautrey, deputy chair of the British Medical Association GP committee: "Many CCGs are still trying to get the right staff in place. All are faced with working out the right relationship between them and the new bodies working with them, particularly the area team of NHS England, local authorities and CSUs."

Jonathon Fagge: "Overall I feel very optimistic about how CCGs have coped with the challenges so far, and are geared for the future. The CCG leaders I meet are ambitious for their organisations, clinically engaged and patient-focused, and ambitious to create a legacy of genuine improvements in healthcare."

Jonathan Sheffield: "The introduction of CCG's offers a real opportunity for clinical involvement in the development and delivery of research. The opportunity to make ground breaking improvements in clinical healthcare is through research and any healthcare provider needs to have an approach to research that ensures that the best, most modern, treatments are made available to patients."

This article is published by Guardian Professional. Join the Healthcare Professionals Network to receive regular emails and exclusive offers.

View the original article here