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CCG constitutions: retaining engagement

CCG constitutions: retaining engagement

Can constitutional amendments be made without the support of the CCG's GP member base?

Posted: 25 April 2016

If you’ve missed yesterday’s episode of this week’s feature on CCG constitutions, click here.

Writer: Rima Evans

CCG constitutions are important legal documents. But to remain flexible and relevant to changes in CCG powers they need to be reviewed and updated regularly.

As membership bodies they should be consulting widely with practices to gauge support for fundamental changes, including taking on greater commissioning responsibilities and making constitutional amendments that reflect those additional powers.

The engagement piece is fundamental in forging strong relationships between member practices and CCG managers, essential for collaborative and joint working.

However, research released last year by the King’s Fund and Nuffield Trust showed that clinical engagement in CCGs declined between 2013 and 2015. The proportion of GPs highly engaged with their CCG decreased from 19 per cent to 11 per cent.

“Those who felt they could influence their CCG work declined from 47 per cent to 34 per cent”, the survey Primary Care Co-commissioning found.

CCGs are working hard to ensure GPs have maximum influence in their direction of travel.

Courtney says: “If there was something of substance that was going to change there would be no question, we would always consult. There has to be consultation with all the membership.”

At Somerset, consultation takes place directly with practices through meetings held at locality level and via the LMC, he says.

North East Lincolnshire CCG has set up a specific forum for GP discussion regarding local developments in general practice. “Discussions regarding required amendments to the constitution are discussed with members at our Council of Members meetings and more detailed debates may take place in task and finish groups, as and when agreed,” it says. Both these meetings are attended by the LMC. And the CCG has an additional liaison meeting in place with the LMC “to ensure that they are also able to participate and communicate relevant matters to their members.”

Herts Valleys uses both informal and formal structures to gauge opinion from members. While explains they use a GP forum bringing all 69 practices together to get informal feedback and opinion. A formal voting process is also used for critical decisions such as moving to co-commissioning. “The ballot allowed one vote per practice. It was organised via the LMC so practices returned their votes to them,” While says.

“This gave it credibility in terms of independence because it was not the CCG board running the ballot. Consultation is very important to this organisation. Most CCGs would want their practices, as members, fully supporting the decisions they make.”