Not another league table…the new Commissioner rankings and the need for scale
My heart sank (for CCG leaders) when I heard that CCGs now face a further, public, ranking exercise by NHS England (See here). I accept there is no room for complacency or incompetence, but the CCGs I know are doing the best in what is still a newish role, against a truly frightening backcloth of financial pressure and the need to make radical service changes.
League tables can make great headlines; they can give a (national) picture of comparative performance. However, learning from education, they often bear little relevance to the actual challenges a CCG may be facing, or the individual support they need.
Talking of need, the biggest problem CCGs have is not of their own making; it is that in many cases, they were created at a scale which is just not big enough to have the resources or reach to deal with the STP-scale challenges they face. Many CCGs recognised this from the outset, being carved out of PCTs which were (just before their abolition) at a much better scale to address the size of problems commissioners face today.
The challenge (in the absence of another dreaded 'top down' reorganisation – which no one wants), is how to scale-up at speed. Fortunately, we are aware of some good examples of shared working, shared teams and shared agendas across CCGs that could achieve a huge amount if allowed to get on with what they instinctively know is needed, without mergers or too much formality. As ever, to make those changes there needs to be an oversight culture of forgiveness, not permission, to get to the necessary scale. So more scale and fewer league tables please!