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Did you know how the establishment of clinical commissioning groups changed the way medical services operate?
The UK National Health Service (NHS) established Clinical Commissioning Groups (CCGs) through the Health and Social Care Act in 2012, with the aim of replacing the then existing strategic health agencies and primary care trusts to better organize local medical services. However, in 2022, CCGs will be replaced by integrated care systems. This change has triggered extensive discussions and thinking about the operating model of medical services.
Background of establishment of clinical commissioning group
The core of this policy is to hand decision-making power over medical services to general practitioners (GPs), hoping to create a more clinically driven commissioning system. This change originated from the "Fairness and Excellence: Unlocking the NHS" white paper published in 2010, and finally became law in 2012. By the end of 2013, a total of 211 CCGs had been established in the UK.
As of 2020, after multiple mergers, the number of CCGs has been reduced to 135.
Structure and operation mode
CCGs are clinical leadership groups composed of general practitioners in each region. In addition to GPs, they also include registered nurses and doctors from different specialties. This organizational structure is designed to give clinical staff greater influence to improve services to patients.
Nearly 80% of CCG chairs are GPs, although in 2014 only a quarter of heads were GPs.
This new operating model brings an emphasis on collaborative medical decision-making and working with local communities and local governments to improve health services. However, the process has not been smooth sailing, with many GPs expressing a lack of participation in the CCG decision-making process and even resistance to the merger.
Impact of merger
With the gradual reduction in the number of CCGs and the emergence of mergers, economic benefits have become a major factor considered by the government. In 2018, the British government announced a 20% cut in some budgets and encouraged savings through mergers. This has impacted the operational flexibility of CCGs, and they are faced with the challenge of maintaining service levels.
Relationship with local government
The establishment of CCGs has also facilitated collaboration with local councils, such as the merger of services with Brighton and Hove City Council, which demonstrates how to avoid duplication of placements in health and social care. As a result, opportunities to improve service quality are greatly increased.
Responsibility and operational challenges
The main responsibility of CCGs is to provide medical services to patients living in their jurisdiction, including planning and monitoring community health services, emergency services and mental health. However, these organizations often face difficulties in actual implementation due to uneven funding distribution and competition for health resources.
In the 2018/19 financial year, UK CCGs were allocated £74.2 billion, with an average budget of £1,254 per registered patient.
Dependence on the private sector
In the process of CCGs operation, more and more private companies have entered the medical market. While this process is intended to improve competitiveness and service quality, concerns have been raised about its potential impact.
Coping with the challenges of the epidemic
The COVID-19 epidemic has caused major challenges to the operating model of CCGs. The government has decided to temporarily let the NHS Commissioning Committee be directly responsible for the procurement of medical services, bypassing the original responsibilities of CCGs. During this period, the role of CCGs was re-examined and faced innovation.
Conclusion
Overall, although CCGs were originally established to promote patient-oriented medical services, they have experienced many challenges during their operation. How will such changes further affect the future operation model of medical services? Will it be able to continue to meet patient needs and be brave enough to face challenges?
