Most second wave CCGs have authorisation conditions imposed

Authors: Helen Jaques 

Publication date:  26 Jan 2013

More than two thirds of clinical commissioning groups (CCGs) in the second wave of groups authorised by the NHS Commissioning Board have had conditions imposed on their new status.

Of the 67 CCGs in the second wave, 45 have been authorised with conditions, meaning that they will receive some formal support to help them fully meet all the criteria. Nineteen of the groups met all 119 authorisation criteria and have been authorised with no conditions.

The CCGs authorised to date cover almost half of England’s local health communities. Those authorised in the second wave will provide health services to more than 18 million people. The 34 CCGs authorised in the first wave in December last year[1] will provide services to around 10 million people.

The NHS Commissioning Board expects that 211 CCGs will be authorised in total, with the remaining 110 to be authorised over the next two months.

Most of the CCGs in the second wave authorised were given between one and 10 conditions. However, Dartford Gravesham and Swanley CCG must meet 22 conditions to be fully authorised.

NHS Nene CCG, NHS Herts Valleys CCG, and NHS Medway CCG have been authorised with “directions.” These are legally binding instructions that formalise the support the groups need for them to meet the conditions of their authorisation. Directions can be used to stop a CCG exercising particular functions and set out how another CCG or the NHS Commissioning Board will carry out those functions.

Barbara Hakin, the NHS Commissioning Board’s national director for commissioning development, said that it is to be expected that CCGs would be at different stages at the time of authorisation.

“At the point of authorisation, a CCG has sufficient building blocks in place to become a mature and developed commissioning organisation,” she said. “Even those CCGs authorised with no conditions at all will be working to make further improvements in the future, and the NHS Commissioning Board will continue to support all CCGs in their development.”

The CCGs together will take over £65bn of the £95bn NHS commissioning budget from 1 April 2013. Budding CCGs are assessed over a five month period by the NHS Commissioning Board to determine whether they meet more than 100 criteria, organised in six domains.


  1. Jaques H. Only a quarter of first CCGs are fully authorised. BMJ Careers  , 13 Dec 2012. [Link] .

Helen Jaques news reporter BMJ Careers

Cite this as BMJ Careers ; doi: