Clinical Commissioning Groups

A Clinical Commissioning Group (CCG) is a group of GPs and other clinicians who have chosen to come together to commission (buy) health services for their local communities. From early 2013, Clinical Commissioning Groups will be responsible for commissioning NHS services for patients inEngland. All GPs will need to be part of a CCG. They will replace Primary Care Trusts (PCTs). CCGs will be responsible for commissioning hospital services (elective, acute and emergency) and most community health services (for example district nurses), and mental health services. The 151 PCTs have already been organised into 51 clusters in preparation for the change. There will be a period of dual functioning as CCGs mature and PCTs delegate more responsibility to CCGs.


The governing bodies (Boards) of the CCGs will have, in addition to GPs, a least one registered nurse and a doctor who is a secondary care specialist. Groups will have boundaries that will not normally cross those of local authorities.

Some CCGs have been given authority by central government to test new models of clinical commissioning and to lead in their development – the term ‘pathfinder’ is used to describe such groups.


Commissioning is the term used in the public sector for buying services. It is a structured way of deciding how public money should be spent. In the case of the NHS, commissioning relates to the provision of health services. Commissioning healthcare and health services is the process of examining:

  • the healthcare needs of the area
  • the way in which healthcare services are delivered
  • ways in which healthcare resources will offer the best overall value for money


Health services, such as GPs and community and hospital services have historically been commissioned by PCTs. This way of buying in services has meant that GPs and other clinicians, who are the best placed to advise on their patients needs, have been too far removed from the process.


The health White Paper: Equity & Excellence: Liberating the NHS was published in July 2010. The White Paper reinforces this view, and in time, much of the responsibility for commissioning health services will be given over to clinicians including GPs.


The CCGs will be overseen by the newly formed independent NHS Commissioning Board which will make sure that CCGs have the capacity and capability to commission services successfully and to meet their financial responsibilities. The NHS Commissioning Board will become fully operational from April 2012. Its senior structures should contain a range of healthcare professionals, and it will have a Medical Director and a Chief Nursing Officer on its board.

The NHS Commissioning Board will also be responsible for directly commissioning:

  • Pharmacy services
  • General Practice
  • Dentistry services
  • Specialist services (specialised services that are required by a limited number of people)

At a local level, new Health and Wellbeing Boards will be set up in local authorities to ensure that CCGs are meeting the needs of local people. The membership of these boards will include representatives from:

  • Clinical Commissioning Groups
  • Directors of public health
  • Children’s services
  • Adult Social Services
  • Elected councillors
  • Health watch (representing the views of patients, carers and local communities)


These boards will be in place in shadow form April 2012.    



For further information

More information on the health White Paper: Equity & Excellence:

Liberating the NHS see the Department of Health website:


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