25 April 2018 update: Since this article was posted Thanet and South Kent Coast CCGs have joined the strategic commissioner.

The Clinical Commissioning Groups (CCGs) across Kent and Medway are looking at options for developing a strategic commissioner function that works across multiple CCGs. The aim is to strengthen how CCGs work together, where doing so can drive service improvements that our patients need and expect.

Making strategic commissioning decisions across multiple CCGs is good because it provides consistency and reduces duplication; both for ourselves and the hospital, community and mental health services we work with. It will help improve services for patients by reducing variation in quality and access to care and will drive up standards across all providers.

A formal proposal to establish a strategic commissioner and share a single senior management team with one accountable officer (chief executive) has been considered by CCG governing bodies in January/February 2018. Six of the eight CCGs have agreed the proposal.

The GP practices who make up NHS South Kent Coast Clinical Commissioning Group met on 22 February 2018 to discuss the proposal. Before taking a decision, they wanted more information on the detail of the proposal and the balance between working at scale, where appropriate, and retaining local autonomy. A further meeting is being arranged and we will update on the outcome once known.

NHS Thanet CCG have decided not to pursue a path to be a part of formal arrangements. However, they will continue to work with the other CCGs on development of the strategic commissioner and on a range of strategic service improvement plans as they recognise that there are functions they currently undertake which could be usefully undertaken at a larger geography.

The strategic commissioner will be established in a shadow form from April 2018. To prepare for the new arrangements the accountable officers of the CCGs are taking on additional transitional roles from February. Details are outlined below:

CCG Accountable Officer Transitional role
Ian Ayres West Kent CCG Medway, North and West Kent Managing Director
Patricia Davies Dartford, Gravesham and Swanley CCG, Swale CCG Director of Acute Strategy
Simon Perks Ashford CCG,
Canterbury and Coastal CCG
Medway, North and West Kent Deputy Managing Director
Caroline Selkirk Medway CCG East Kent Managing Director
Hazel Smith South Kent Coast CCG, Thanet CCG Director of Partnerships

In the coming months all the CCGs will be involved in the design of where the different functions of commissioning need to sit and how to ensure the local voice of clinicians and patients is heard at the strategic level. We will be working with staff, member practices and lay-members of the CCGs to consider how current functions should be split across a strategic commissioner and individual CCGs.

Could this lead to the CCGs merging?
A merger of CCGs is one potential option for the longer-term which we will be discussing in the coming months, but it is not the only option and no decisions have been made at this stage. A proposal to merge would require all the CCGs involved to engage and seek the views of their membership practices and other stakeholders, and NHS England would also have to approve.

System transformation pages