NHS England is an independent body, its main role being to set the priorities and direction of the NHS in England and to improve health and care outcomes for people in England.
NHS England is the main commissioner for primary care services such as GPs, pharmacists and dentists and oversees Clinical Commissioning Groups (CCGs), as well as other bodies. Read more about NHS England
Recently, NHS England invited CCGs to take on a bigger role in commissioning and so NHS England and CCGS often co-commission services. NHS England funds CCGs for commissioning services locally. Read more information about co-commissioning
Clinical Commissioning Groups (CCGs)
Clinical Commissioning Groups (CCGs) were created following the Health and Social Care Act in 2012. CCGs are responsible for the planning and commissioning of healthcare services for their local area. They assess local needs, decide priorities and strategies, and then buy services on behalf of the population from providers such as hospitals, clinics, community health bodies, etc.
What are CCGs and what do they do?
CCG’s are membership bodies with local GP practices as members. The members set out in their constitution the way in which they will run their CCG. Constitutions are agreed with NHS England and published.
CCGs are led by an elected governing body made up of GPs, other clinicians including a nurse and a secondary care consultant, and lay members. All GP practices belong to a CCG.
They are responsible for approximately two-thirds of the total NHS England budget and are responsible for commissioning healthcare such as mental health services, urgent and emergency care, elective hospital services, and community care.
Commissioning involves deciding what services are needed and ensuring they are provided in the local area. They are independent bodies and accountable to the Secretary of State for Health through NHS England.
Who is responsible for CCGs?
CCGs work closely with NHS England, who have a responsibility to assure themselves that CCGs are fit for purpose and are improving health outcomes and must help support the development of CCGs. As co-commissioners with NHS England, CCGs work with NHS England’s Regional Teams to ensure joined-up care.
Do CCGs work with any other bodies?
CCGs work closely with local authorities through health and wellbeing boards to achieve the best possible outcome for the local community, by developing a joint needs assessment and strategy for improving public health.
Health and Wellbeing Boards
Health and Wellbeing Boards are set up in every area. They work to protect and improve the nation’s health and to address health inequalities.
They bring together local commissioners from the NHS, public health and social care elected representatives and representatives of Healthwatch to plan how to meet local health and care needs and to commission services accordingly.
Visit the Kings Fund Health and Wellbeing Board map to find contact details of your local Health and Wellbeing Board, the relevant Clinical Commissioning Group for that contact, links to the Healthwatch websites, Joint Strategic Needs Assessment websites, the Health and Wellbeing Strategy websites and the Pharmaceutical Needs Assessment websites
Healthwatch is the national consumer champion for both health and social care. They have considerable statutory powers to make sure that patients’ voices are heard. There are two strands of Healthwatch:
Healthwatch England is a national body that represents the views of the public to make sure that the voices of the people who use health and social care services are heard by the Secretary of State, the Care Quality Commission, the NHS Commissioning Board, Monitor and every local authority in England.
Their sole purpose is to understand the needs, experiences and concerns of people who use health and social care services and to speak out on their behalf.
They actively seek views from all sections of the community via Local Healthwatch by conducting research in local areas and identifying gaps in services. This information is then fed into local health commissioning plans.
There is a local Healthwatch in every local authority area in England. Each Local Heathwatch is a social enterprise (an organisation that applies commercial strategies to maximize improvements in human and environmental well-being). They are independent organisations able to employ their own staff and volunteers.
Every Local Healthwatch:
- has powers such as establishing relationships with local authorities, CCGs, patient representative groups, the local voluntary and community sector and service providers to ensure it is inclusive and truly representative of your local community
- gives people and communities a stronger voice to influence and challenge how health and social care services are provided within their area
- enables people’s views and concerns about their local health and social care services to be shared and understand that their contribution will help build a picture of where services are doing well and where they can be improved.
- has a seat on the Health and Wellbeing Boards, ensuring that the views and experiences of patients, carers and other service users are taken into account when local needs assessments and strategies are prepared, such as the Joint Strategic Needs Assessment (JSNA) and the authorisation of Clinical Commissioning Groups. Healthwatch has a role in promoting public health, health improvements and in tackling health inequalities
- is funded by local authorities and held to account by them for their ability to operate effectively and be value for money.
- provides or signposts people to information about local health and care services and how to access them. They also provide people with information about their choices and what to do when things go wrong. This includes either signposting people to the relevant provider or providing (if commissioned by the local authority) support to individuals who want to complain about NHS services.
- has the power to enter and view services being provided and be able to alert Healthwatch England and the Care Quality Commission to any concerns about specific care providers.
- will provide authoritative, evidence-based feedback to organisations responsible for commissioning or delivering local health and social care services.
The Local Healthwatch websites have information on events, consultations etc and have a newsletter so that you can keep up to date on what is happening in your local area. You can also give feedback or review any services you have used in your area.
Joint Strategic Needs Assessments (JSNAs) and Joint Health and Wellbeing Strategies (JHWSs)
A Joint Strategic Needs Assessment (JSNA) is an assessment of health and social care needs of local populations that then informs and guides local authorities, Clinical Commissioning Groups (CCGs) and local partners in the planning and commissioning of services in the local area.
A Joint Health and Wellbeing Strategy (JHWS) is a strategy (plan) for meeting the needs identified in JSNAs.
Both JSNAs and JHWSs, are prepared by local authorities and CCGs and are unique to each local area. The Health and Wellbeing Boards, however, have overall responsibility for these.
JSNAs provide analyses of data to show the health and wellbeing status of local communities, define where inequalities exist, provide information on local community views and evidence of the effectiveness of existing interventions which will help to shape future plans for services and make specific recommendations based on the information and evidence collected.
Health and Wellbeing Boards can request relevant information from members and other organisations when preparing JSNAs or JHWSs and they have a duty to supply the information.
The JHWSs should explain what health and wellbeing priorities the Health and Wellbeing Board has set. They should be available for download from your local authority.
Visit the Kings Fund Health and Wellbeing Board map to find contact details of local Health and Wellbeing Boards, the relevant Clinical Commissioning Group for that contact, links to the Healthwatch websites, Joint Strategic Needs Assessment websites, the Health and Wellbeing Strategy websites and the Pharmaceutical Needs Assessment websites.