The final wave of clinical commissioning groups have been rolled out in England as they look to take control of £65 billion worth of NHS budget next month. 

The NHS Commissioning Board, which is responsible for the CCGs, says that all 211 of these groups are ready to take up their statutory responsibilities to commission health services in their area.

The fourth and final group of 48 organisations – called clinical commissioning groups (CCGs) – were authorised following an assessment by experts.

CCGs will be responsible for £65 billion of the £95 billion NHS commissioning budget. They plan and commission hospital, community health and mental health services on behalf of almost all of England’s population, taking over from the soon-to-be abolished PCTs and SHAs.

The members of CCGs are GP practices meaning that all of England’s 8,000-plus GP practices will be involved in commissioning healthcare.

Every CCG board will also include at least one hospital doctor, nurse and member of the public. It was originally designed to be just GPs, but the UK Government made amendments to this in 2011 during its ‘listening exercise’.  

Dame Barbara Hakin, NHS commissioning board national director for commissioning Development, said: “This is a tremendous achievement by CCGs which have shown remarkable enthusiasm for and commitment to bringing the benefits of clinical commissioning to their local communities and are now on the threshold of taking up their new role.

“But it is just the beginning: these new organisations will continue to need to develop and grow, bringing real, tangible benefits to patients and local communities.”

The 211 CCGs, introduced by the Health and Social Care Act 2012, will from 1 April 2013 replace the 152 primary care trusts that currently commission healthcare services.


But before these groups can take on full responsibility, they must complete a process known as authorisation. This is granted after experts have ensured the CCG is safe and effective through a rigorous assessment process which includes reviewing the CCG’s policies, carrying out site visits, looking at its leadership and its work with stakeholders and the public.

But in total, just 43 of the 211 CCGs have been fully authorised, meaning they met all 119 criteria for authorisation. A further 168 CCGs have been authorised with ‘conditions’, meaning they have some additional work to do before they fully meet the criteria.

A total of 15 CCGs have also been issued with legal directions, meaning the NHS Commissioning Board will ensure that these groups are working effectively, as they have fallen far below the standard expected of them.

The NHS Commissioning Board will, later this month, re-assess all CCGs which were authorised in the first three waves of the process. These CCGs have continued to develop and many are expected to be able to discharge the majority of conditions on their authorisation. CCGs authorised in wave four will be reviewed in June 2013.