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Councils should co-commission public health with CCGs – Hunt

Public health commissioning arrangements should change so that local authorities co-commission alongside CCGs, according to Jeremy Hunt.

Giving a keynote address at the Best Practice Show in Birmingham last week, the health secretary called for CCGs to become ‘Accountable Care Organisations’ and to expand their role from commissioning secondary care to also co-commissioning primary care and social care, alongside NHS England, and co-commissioning public health with councils.

It was the coalition government that took many areas of public health commissioning responsibility away from the NHS and gave it to local authorities and Public Health England when it passed the Health and Social Care Act 2012. Making changes to give CCGs co-commissioning responsibility could be an acknowledgement by the government that this was a mistake.

The Royal Society of Public Health welcomed the idea of closer integration but told NHE that it believes the current commissioning arrangements need time to “bed in” before any changes are made.

Shirley Cramer, CEO of the Royal Society for Public Health said: “Local authorities and CCGs are already working together through Health and Wellbeing Boards and they need to be given time to allow this relationship to develop. In a perfect world joint commissioning arrangements between the CCGs and local authorities would already be in place but the complexity of current commissioning arrangements means we aren’t really clear whether there should be a one size fits all approach with CCGs at the centre. Any changes to extend the role of CCGs into public health and social care will need to take into the resource implications, to provide the appropriate infrastructure and systems and to manage budgets and resources.” 

Hunt views joining up care and the co-commissioning arrangements as essential, so that public health campaigns conducted by national and local government can be linked with the work done in GP surgeries.

He said: “I’d like to see CCGs, clinically-led, becoming Accountable Care Organisations, responsible for all the care of the populations they look after. Not just commissioning secondary care but, with the Better Care Fund, co-commissioning social care, with NHS England co-commissioning primary care and with local authorities co-commissioning public health. Because I think we have to join this up and we have to think about healthcare much more holistically that has happened in the past.

“We really need to link up the public health campaigns conducted by national and local government with the work done by GPs and practice nurses in GP surgeries. I think CCGs can be the spider in the centre of the web, working closely with lots of other people.”

PSE asked the Local Government Association and NHS Clinical Commissioners for comment but they had not responded by the time of publication.

(Image: c. Joe Giddens/PA Wire)

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