Research report
26 Jan 2015


As clinical commissioning groups (CCGs) settle into their central role in the reformed NHS, the full scale of the challenges they face is becoming clear. This report, part of a joint project by the Nuffield Trust and The King’s Fund, aims to understand the development of CCGs, and to support them by spreading good practice and learning.

It tracks the development of six CCGs, selected to broadly represent CCGs across England. The report, which is based on a survey, interviews, observations and reviews of board papers, considers two research questions: how CCGs are functioning as membership organisations and how they are supporting the development of primary care in their local area.

“Our research shows that the future of the clinical role in commissioning healthcare remains fragile. While CCG leaders overall are still highly engaged in their work, our fieldwork and survey revealed this is waning and there are some worrying signs emerging over strained resources – both time and money. CCGs are set to be stretched yet further as they adapt to new and expanded roles.”

Holly Holder, Fellow in Health Policy, Nuffield Trust and report co-author

The report authors found that:

  • CCG leaders questioned whether they had sufficient capacity to expand into primary care commissioning.
  • While the majority of CCG leaders felt that conflicts of interest were being managed adequately, researchers highlighted examples of decisions where there was the potential for conflict.
  • Few GPs felt that managing GP performance – something that contract management responsibilities under co-commissioning may lead to – was an appropriate role for CCGs.

The study outlines a number of key recommendations to CCG leaders and NHS England to assist CCGs in making the transition to co-commissioning and ensure the sustainability of CCGs. 


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