The relationship between Clinical Commissioning Group (CCG) and practice should be characterised by genuine clinical engagement and collaboration. The CCG should not be seen to regulate or penalise practices and practices need to feel empowered to hold their CCG to account for the decisions made on their behalf. The CCG constitution will play an important role in determining the relationship between practices and CCGs.
Your CCG Constitution. . .
The constitution should be limited to governance arrangements of the CCG and should not place any contractual or performance requirement on practices.
A good constituion should NOT include:
- Clauses to ‘expel’ practices, whether on the grounds of ‘poor performance’ or if they fail to follow CCG policies. CCGs will not have the power to expel practices or to apply economic sanctions against them.
- Clauses relating to the performance management of practices. These may be basedupon budgetary considerations, relating to prescribing, referrals and emergency admissions. Although it is important that CCGs have access to data relating to patient management, this should not be used to penalise practices, but to understand the reasons for variation and improve outcomes.
- Clauses relating to monitoring of areas covered by the GP contract.
A good constituion should:
- Be confined to governance and operational remit.
- Be a clear and concise summary of key points for practices.
- Ensure all practices are represented in the process by defining the involvement of the LMC.
- Clearly outline the dispute process by which practices can raise grievances with their CCG.
Your LMC. . .
We urge all practices to reassure themselves of the appropriateness and content of their proposed CCG constitution, to seek advice from their LMC and to use GPC guidance as an aid. CCGs are membership organisations and CCGs have no right to compel practices to sign a constitution with which they are not content. A practice has the right to refuse to sign these documents until their concerns have been addressed by the CCG.