In Gloucestershire the Clinical Commissioning Group that will take over commissioning of secondary healthcare from NHS Gloucestershire (the PCT) in April 2013 already exists as a shadow board. The board holds meetings in public, and I attended the second of them on June 21st. Three other members of the public were present.
The abbreviation CCG means either or both Clinical Commissioning Group and Clinical Commissioning Gloucestershire. CCG published the agenda and other papers for the meeting here: Papers for the June Meeting (168 pages in all)
The meeting was pacy and difficult to follow without a fairly thorough grasp of the papers beforehand. I thought there were clear signs that GPs on the board were contributing from experience, and it was encouraging to note this aspect of the NHS reforms beginning to gel. (CCGs were originally to be called “GP consortia” to emphasize the role of GPs in them.)
For example, in the discussion on non-urgent patient transport, it was pointed out that the existing eligibility criteria were not well known and inconsistently applied. When a better system is implemented there will appear to be “winners and losers” even without any change in the criteria.
I thought it was valuable to attend to understand this kind of perspective, which does not come across just from reading the papers. In addition, some information is given verbally at the meeting and does not appear in print.
For example, in the discussion on commissioning for quality it was reported that in relation to surgical procedures there had been four “never events” (mistakes, essentially, that are never ever supposed to happen), and that this information is not in the report. This news was immediately followed up with an assurance that services are “nevertheless” safe, without any grounds being given for the assurance.
The public are only observers at these meetings, but they can submit questions to the board either in advance or at the meeting. I submitted a question in advance about the national Improving Access to Psychological Therapies programme (IAPT) in relation to Gloucestershire’s “Let’s Talk” service, which is supposedly an IAPT service but didn’t meet the national targets in 2011-12. A prepared reply was read out, which barely addressed the question but did confirm that Gloucestershire’s target was a fraction of the national target.
Overall I thought the meeting was worthwhile for interested and informed members of the public, even though it is quite easy for any organization to stage-manage events like this so as to conceal anything they want to conceal.