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Thursday 29 September 2016
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Francis report: CCGs held to account

Clinical commissioning groups will be “held to account” for quality outcomes in their area, the government has announced. 
In response to the Francis report, which was released just over two months ago, Health Secretary Jeremy Hunt said commissioners will have to work with hospitals to identify and tackle poor care. 
“Local clinical commissioners are going to have an incredibly important role because they’re the ones who are signing contracts with hospitals in their area,” said the Health Secretary. 
“There may be no practical alternative to the local hospital for the population that they’re serving, but this system will mean with a rigorous inspection routine and a failure system that can’t be ducked, that [commissioners] can be confident any problem that may arise can be sorted out,” he said. 
Holding to account
The NHS Commissioning Board (which will now be called NHS England to clarify its role) will have the power to intervene when there is evidence that a CCG is failing. 
In turn, the NHS Outcomes Framework will be used “to hold the NHS Commissioning Board to account” for the improvements it makes in the commissioning of health services. 
“The NHS and its staff do not need to wait for the government to legislate or for guidance from national bodies,” the report said. 
 
“For real change to occur local staff and local leaders must embrace the need for fundamental change.” 
The Care Quality Commission (CQC) will become the “primary assessor of quality in the health and social care system”.
A hospital assessment method will be agreed with Monitor, NHS CB and the NHS Trust Authority to ensure the care is provided in a way which sets out commissioners’ expectations. 
New roles
The government has also announced two new roles – a Chief Inspector for Hospitals and a Chief Inspector of Social Care. 
The Chief Inspector of Hospitals will introduce and develop ‘Ofsted-style’ ratings of hospital performance, and the Inspector of Social care will “ensure the same rigour is applied across the health and care system”. 
The new regime will “give patients and the public a fair, balanced and easy to understand assessment of how well a provider is doing relative to its peers”, the report said.
“A Chief Inspector of Social Care will ensure that we don’t become hospital centric, but we have someone who can look at the wider care system to ensure that the same principles apply across the board,” Norman Lamb, Minister for Care and Support said. 
DH is also discussing the possibility of introducing a Chief Inspector of Primary Care. 
Although the Health Secretary said changes announced today would apply to the whole healthcare system, a response specific to primary and community care will be released in the coming year. 
The Health Secretary said: “Today I am setting out an initial response to Robert Francis’ recommendations. But this is just the start to a fundamental change to the system.”