Yesterday, the government published the list of the 212 Clinical Commissioning Groups that are to be established throughout England. Some will serve populations as low as 67,000 while other super-CCGs will cater for nearly 1 million patients. (see the full list here).
For the first time the government have published an expectation of the costs in running their new CCG structure. A closer examination of the government's data shows that annual costs just to run the CCGs will amount to £1.334 billion a year. Over the course of a parliamentary term this is a combined running cost of £6.67bn. The chairs of the CCGs will for 2 days work a week be given £40,000 each. Two other part time staff will earn smaller sums of £25k. In terms of the calculation of the running costs, there also appears to be some disparity. By dividing total running costs by the number of patients a CCG expects to serve, we can say that some CCGs such as North Somerset CCG will cost £26 per patient to run, while other CCGs such as Brent or Lambeth will be allocated just £21 per patient. Quite why some CCGs are being allocated 25% more funds to run their CCG is not clear.
I see no reason why we cannot call these CCGs quangos myself, which after Cameron's promise to have a bonfire of quangos one must ask if the creation of 212 CCGs was counter-productive to that goal.
The government's lack of direction in guiding CCGs on appropriate sizes and mergers has undoubtedly part caused this disparity. One of the chief consequences of it is that inequality & the post code lottery has been exacerbated because wealthier areas have joined together to form larger CCGs and excluded neighbouring GP practices from poorer areas from merging with them. Pulse have reported that the areas most likely to suffer as a result are the West Midlands, and in particular Birmingham, as well as the East of England (see more of Pulse's research here).