Clinical Commissioning Groups (CCGs) were organizations within the National Health Service (NHS) in England, established by the Health and Social Care Act 2012. They replaced Primary Care Trusts and became operational in April 2013. CCGs were locally-based, statutory NHS bodies responsible for planning and purchasing health services for their geographical population and managing the local NHS budget. CCGs are now historical bodies, having been formally dissolved in July 2022 to make way for a new structure within the NHS.
The Core Role of Clinical Commissioning Groups
The primary function of a CCG was to commission healthcare services tailored to the specific needs of its local population. This involved assessing local health requirements, deciding which services to fund, and monitoring provider quality. CCGs managed approximately two-thirds of the total NHS England budget.
They secured a wide range of services from providers, including hospitals, community health bodies, and mental health trusts. This included non-specialist hospital care (such as elective surgery), urgent and emergency care, mental health services, learning disability services, and rehabilitation care.
CCGs also purchased community health services and handled individual funding requests. By assessing local needs and setting priorities, they aimed to improve health outcomes for their population.
How CCGs Were Structured and Governed
CCGs were membership organizations, with all local General Practitioner (GP) practices automatically becoming members. This structure ensured clinical leadership and gave frontline clinicians direct influence over local spending decisions and patient pathways.
Each CCG was overseen by a governing body responsible for effective and efficient operation. The mandated composition required diverse expertise, including GPs, at least one registered nurse, and a secondary care doctor from outside the CCG’s local area.
The governing body also included lay members. One lay member focused on patient and public involvement, while another oversaw financial management and audit functions. CCGs were accountable to NHS England for their financial management and performance.
The Shift to Integrated Care Boards
The CCG model ended on July 1, 2022, when the Health and Care Act 2022 abolished them as statutory bodies. This shift was motivated by a move toward more integrated health and care planning across wider geographical areas.
The successors to the CCGs are Integrated Care Systems (ICSs), which operate across 42 areas in England. Each ICS is composed of two statutory parts: the Integrated Care Partnership (ICP) and the Integrated Care Board (ICB).
The ICBs are the statutory NHS organizations that absorbed the commissioning functions previously held by CCGs. ICBs operate on a larger geographic scale than CCGs, aiming to improve population health and tackle health inequalities. Their mandate focuses on collaboration between the NHS, local authorities, and the voluntary sector to provide more joined-up services, enhance productivity, and improve value for money.