Feature / Introduction to...CCG allocations

The NHS Commissioning Board (NCB) is due to authorise the first clinical commissioning groups (CCGs) next month. These, along with those authorised in three more waves in the coming months, will begin operating from next April.

While some CCGs have already taken responsibility for commissioning specific services (delegated to them by their primary care trust), from next April they will begin to decide how to spend an estimated £60bn to meet their patients’ needs and priorities.

CCGs will learn their final budgets for 2013/14 in mid- December. The NCB and the Department of Health are working

with an independent panel of experts (the Advisory Committee on Resource Allocation) to develop a fair shares formula on which the allocation of funds to CCGs will be based.

In April this year then health secretary Andrew Lansley suggested the age of the population rather than indices of deprivation should be the principal determinant of health need, but this does not appear to be part of the current thinking.

Unlike previous formulae used to allocate funds to primary care trusts, the NCB says fair shares will be based on the number of patients registered to each practice in a CCG (much like payments to GP practices for the provision of primary care).

It will use patients’ diagnosed conditions to assess the overall level of need of those living in the area covered by the CCG. Birth rates, levels of mental health service use and local market factors that make costs higher in some areas will also be taken into account.

Though CCG allocations will be based on fair shares at some point, the NCB concedes it may not be used to allocate budgets for 2013/14. It is currently finalising CCG baseline allocations based on historic PCT funding levels. Once the NCB receives confirmation of its mandate funding, expected this month, it will be in a position to make final allocations to CCGs. At this point it says a decision will be made on whether to use the new formula for 2013/14 allocations.

For the first time, funding for commissioners will be separated from their running costs. This aims to ensure that money allocated for healthcare is spent on frontline services. CCGs will receive £25 per head of population to pay their running costs.