CCG mergers: How CCGs and local government can work together

CCG mergers: How clinical commissioning groups and local government can work together
NHS Clinical Commissioners 4 September 2020

• NHS England and NHS Improvement’s guidance for CCGs planning to merge outlines that there will be consideration of whether proposed new CCGs will be “coterminous” with one or more upper-tier county council or unitary local authority (ie cover the same geographical area). NHS Clinical Commissioners and Local Government Association have developed an interactive discussion guide to assist CCGs and local government colleagues to have open conversations and identify any issues that may arise from mergers.

Procedures for CCGs to apply for constitution change, merger or dissolution – updated 3 August 2020

Procedures for clinical commissioning groups to apply for constitution change, merger or dissolution 
NHS England 15 April 2019 updated 3 August 2020

• Policy and procedures to be followed by CCGs and NHS England in the circumstances of a CCG wishing to apply to make changes to its constitution or to dissolve or two or more CCGs wishing to apply to merge.
• Update August 2020 takes account of learning from a large wave of CCG mergers in 2019/20.

Does hospital competition reduce rates of patient harm in the English NHS?

Does hospital competition reduce rates of patient harm in the English NHS?
Competition and Markets Authority 31 January 2019

• Previous hospital mergers have reduced the number of distinct organisations offering publicly funded and provided care in the NHS, reducing choice and between-hospital competition in some areas. 
• This paper tests the impact of variation in concentration on a new quality indicator: the prevalence of patient harm from falls, pressure ulcers, blood clots and urinary tract infections. Analysis finds a significant inverse relationship between concentration and quality. Specifically, estimates imply that a hypothetical merger to monopoly would, on average, be associated with a significant increase in harm rates. 
• In addition to the direct effect on patients’ well-being, even small gains to health from competition would likely give rise to large savings for the taxpayer because of reduced treatment costs.

CCG mergers to take effect from 1 April 2018

CCG mergers to take effect from 1 April 2018
CCG Bulletin 15 March 2018

• NHS England has confirmed the conditions have now been met to enable 18 existing CCGs to merge from 1 April 2018. The existing CCGs will be dissolved and six new CCGs will be formed:
• Birmingham and Solihull; 
• Leeds; 
• Bristol, North Somerset and South Gloucestershire; 
• Buckinghamshire; 
• East Berkshire; 
• Berkshire West. 
• Following the mergers, there will be a total of 195 CCGs in England.

CCG mergers

The changing CCG landscape
HSJ 15 August 2017 (Subscription required)

• HSJ has updated their map of CCGs which have merged, are in talks to join together or share a leader.
• The map will be updated as new arrangements emerge.

Information about how the CMA processes HES data

Information about how the CMA processes HES data
Competition and Markets Authority 21 April 2017

• This document sets out how the CMA acquires, uses and protects HES data, which is provided by NHS Digital, in order to fulfil its statutory duties in merger control, and to undertake research to help fulfil its merger control functions.

NHS England Board meeting 15 December 2016

NHS England Board meeting 15 December 2016

• Papers available here.
• Video will be available here

Agenda

• Minutes of meeting 29 September 2016
• Item 2: Chairman’s Report – Verbal report
• Item 3: Chief Executive’s Report – Verbal report
• Item 4: Taking the cancer strategy forward: programme update
• Item 5: Update on the 17/18-18/19 operational planning and contracting round
• Item 6: Sustainability and Transformation Plans
• Item 7: NHS England Corporate and NHS Performance Report
• Item 8: NHS Finance Report
• Item 9 ia: Commissioning Committee on 28 September 2016
• Item 9 ib: Commissioning Committee on 13 October 2016.
• Item 9 ic: Commissioning Committee on 17 November 2016.
• Item 9 ii: Investment Committee 
• Item 9 ii: Specialised Services Commissioning Committee

Highlights :

NHS Mergers - the evidence

Foundation trust and NHS trust mergers 2010 to 2015
Kings Fund 24 September 2015

• This report looks at 20 mergers between 2010 and mid-2015 and finds that significant sums of money are being spent on such mergers (£2 billion on just 12 mergers over this period), often based on faulty reasoning and a lack of evidence that mergers offer lasting solutions.

Three CCGs in Newcastle and Gateshead authorised to merge

Three CCGs in Newcastle and Gateshead authorised to merge
30 July 2014

• NHS Gateshead CCG, NHS Newcastle North and East CCG and NHS Newcastle West CCG, will become a single statutory body from April 1, 2015.

CCG merger announced

Gateshead, Newcastle North  and East and Newcastle West CCG merger announced
HSJ 21 February 2014 (Subscription required)

• Gateshead, Newcastle North and East and Newcastle West CCGs have worked collaboratively since authorisation (see http://gatesheadccg.nhs.uk/about-us/our-history/) but have announced that have started consultation around a merger.
• Merger letter