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Engaging with your CCG

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In this section we set out a five step practical plan for how voluntary organisations can engage with their local CCG. We recommend you read the ‘How clinical commissioning groups operate and their main responsibilities’ page before using the plan.

1.  Do your homework

It is important to have a clear idea of what CCGs do and how they work in practice in your area from the outset. Collecting this information will give you a better idea of how the CCG actually operates, where the influence lies and who is already engaging with the CCG. Although the governing body is responsible for the key decisions of the CCG, it may be that important discussions are held elsewhere; for instance, in a sub-committee or within a locality structure.  The following list sets out some of the pieces of information key to gaining this understandingunderstanding:

  • The area the CCG covers and who the member GP surgeries are
  • The CCG constitution which sets out governance arrangements for the CCG, including the role of the member council
  • The ways in which the CCG is working with other CCGs in the area, including what, if any, functions they share
  • The composition of the governing body, including the identity of the patient and public lay member
  • Any sub-committees which exist on the governing body, when they meet, who sits on them and what their remit is
  • Which CCG meetings you can attend – governing body meetings may be held in public and attendance arranged on request, but sub-committee meetings are almost always held in private
  • The identity of senior members of the executive team supporting the work of the CCG and any lead manager for engaging with the voluntary sector
  • Commissioning plans, along with the agenda and minutes from the most recent meetings – typically available on the CCG’s own website
  • The functions which the CCG has kept in house and the functions it has outsourced
  • The identity of any provider of commissioning support services and the specific services that they provide
  • The extent to which the voluntary sector is already engaging with the CCG, including the ways in which it inputs at different points in the commissioning cycle and the services which the CCG has already commissioning from the sector.
  • The gaps which exists in voluntary sector engagement with the CCG
    Emerging trends on how the CCG works and what approaches it takes.

Regional Voices' Who's Who Guides in Health and Social Care give an overview of CCGs and CSUs in each region. You can find CCGs in your area, along with links to individual CCG websites and member GP surgeries using the NHS Choices search function.

2.  Make the case for voluntary sector involvement

NHS England is working to ensure CCGs have the tools to build partnerships with the voluntary sector: NHS England’s Five Year Forward View emphasises stronger partnerships between the NHS and voluntary organisations. However, for CCGs who have limited previous experience of the voluntary sector or preconceived ideas about how it operates, it is useful to be able to make a concise case on the value you can add.

Five reasons for public bodies to work with voluntary sector organisations:

Expertise: by working with geographic or thematic communities – often over the course of many years – voluntary sector organisations have detailed knowledge of local community safety issues and how to respond to them

Value driven: the ultimate goal of the voluntary sector is to meet the needs of it beneficiaries, so it will often deliver added value.

Innovation: voluntary sector organisations can often identify problems and start experimenting with solutions more rapidly than the statutory or private sector – particularly when they are grant funded. 

Preventative services: the voluntary sector excels in early intervention, prevention and holistic services which reduce the need for individuals to rely on statutory services later on.

Contact with underrepresented groups: voluntary sector organisations reach people who are less likely to be heard by government, ensuring that policies take into account the needs of all sections of society.

The NPC’s report, ‘Supporting good health: the role of the charity sector’, sets out further arguments which can be useful when making the case for voluntary sector involvement. CCGs who understand the sector are more likely to take action to overcome the barriers to engagement considered below.

While it is understandably easy to focus on delivery of services, it is also important to remind the CCG why the sector exists and what makes it distinctive. Having this conversation is particularly useful in persuading the CCG why grant rather than contract funding might be appropriate.

CCGs have the power to give grants to voluntary sector organisations (section 14Z6(1) Health and Social Care Act 2006). The following points below help make the case for why your CCG should make use of this power:

  • Drive innovation: Grants allow voluntary organisations to develop innovative and creative approaches to improving health and wellbeing.
  • Build capacity: Grants can support the development and capacity of the local infrastructure organisations, allowing the sector to co-ordinate in engaging with the CCG.
  • Promote small charities: Smaller charities make things happen for local people but often do not have the resources or expertise to negotiate complicated contracts – small grants can make a significant difference.
  • Proportionate funding: While contracts can be a useful tool in providing incentives and measuring impact, the costs of bidding, negotiating and administering can be disproportionate to the value of the services.

Regional Voices has supported NHS England to provide a ‘Bitesize Guide to Grants’, to help overcome some of the barriers that CCGs are finding to using grants.

3.  Create clear channels of communication

The first part of creating good communication channels is determining the best way of engagement. The following list sets out some points to consider when deciding who to target:

  • Make sure it is really the CCG that you want to engage with. Consider why it is you are approaching the CCG, and not the HWB, the CSU, the council etc.?
  • Who do you already know who feeds into the work of the CCG? This could be GPs, governing body members, individuals on the executive team or in the CSU. Do you know anyone who is already in contact with the member for public and patient engagement?
  • Who has the discussions and makes the decisions you care about? Remember that the important meetings might be at a sub-committee or locality level rather than at the governing body itself.
  • Who in the voluntary sector is already engaging with the CCG? Is there a co-ordinated way in which the wider sector feeds into the CCG?
  • How does the CCG engage with patients and the public? Is this function outsourced to a CSU or is it carried out by the CCG itself?

As CCGs become established, common barriers to engagement have emerged, including:

  • Needing to engage with several CCGs
  • CCG engagement focused on Healthwatch
  • CCG focused on patient participation groups
  • Disproportionate contracting requirements
  • Lack of clarity about where commissioning responsibilities lie
  • Small organisations being drowned out

One of the most effective ways of tackling these barriers is ensuring that the voluntary sector is co-ordinated in its approach to the CCG. This can be challenging in an environment where many infrastructure organisations are losing their core funding or where competitive bidding erodes goodwill and the possibility of sharing intelligence. However, it is clear that many CCGs do not have the capacity or the ability to engage with a diverse voluntary sector. Whether it is through the local infrastructure (in some areas, infrastructure organisations are negotiating funding from CCGs to perform the co-ordinating function) or another route, it is important that the sector is able to provide a coherent front. 

4.  Demonstrate your impact

The crucial point is to be able to demonstrate that you are solving a problem that the CCG cares about. The best way to think about this is by putting yourself in the CCG’s shoes and explaining why what they need is something that you are well placed to assist with.

Impact and solutions

  • Review your evaluation processes – do they demonstrate that you are delivering social value and value for money?
  • Get the numbers right, but also make the most of qualitative evidence – remember that you are best placed to gather the stories of the people you work with.
  • Adopt the language of the CCG as much as possible, using documents such as commissioning plans and the constitution. The more you can use their reasoning to make your case, the more persuasive you will be.
  • Consider how your proposal helps the CCG fulfil its duties: for instance in relation to promoting innovation, reducing health inequalities or promoting patient participation.
  • Become familiar with the local joint strategic needs assessment and the joint health and wellbeing strategy and find examples of other JSNAs and JHWSs that adopt an approach that you are advocating.
  • Be aware of what other CCGs are doing in the area that you work in.
  • Be able to articulate the future of the service you provide.
  • Demonstrate the value of the particular funding type that you are advocating for.

There are also a number of publicly available sources of data which can be used to bolster your case. One East Midlands, (Regional Voices’ East Midlands network) and Public Health England have been working collaboratively on a project to support voluntary sector organisations use ‘open or free’ data sources (such as Public Health England’s Data and Knowledge Gateway, the Office for National Statistics, and the Health and Social Care Information Centre data catalogue). The project, ‘Better Data - making the third sector business case for health improvement’ aims to support organisations to use this data effectively to support business case development. Key data sources of use to the voluntary sector can be found on the Regional Voices Evidence Pages.

5. Encourage Compact working

The national Compact and local Compacts

The Compact is the agreement between government and the voluntary sector in England. It sets out key principles which establish a way of working that improves their relationship, in order to achieve common goals for the benefit of communities and citizens in England.

Local Compacts are often based on the national Compact but tailored to reflect the needs of each community. Local Compacts often have signatories, such as the local Council for Voluntary Service, the local authority and Clinical Commissioning Group. Some PCCs are also signed up to their local Compact. Compact Voice’s map of local Compacts will help you find your local Compact and the main point of contact.

Using Compact principles

The national Compact is made up of five key principles, each of which sub-divides into a number of specific undertakings on government and/or the voluntary sector:

1. Strong, diverse and independent civil society

2. Effective and transparent design and development of policies, programmes and public services

3. Responsive and high quality programmes and services

4. Clear arrangements for managing change

5. A fair and equal society

Each principle is sub-divided into a number of undertakings made by government and / or the voluntary sector. These undertakings are more than abstract concepts – they are concrete steps which can help ensure that the voluntary sector is not an optional extra, but a co-producer and provider. Using the national Compact as an example, the table below shows how undertakings within Compacts can be used by the voluntary sector to push for real change.

           


Undertaking

Application to CCG

1.4

Ensure greater transparency by making data and information more accessible.

Encourage the CCG to produce high quality agendas for meetings, with graphic overviews, summaries and highlighting significant risks, issues and exceptions

2.2

Consider the social impact that may result from policy and programme development.

Encourage the CCG to publish and adhere to a commissioning and procurement plan which embeds social value

3.2

Consider a wide range of ways to fund or resource civil society organisations.

Remind the CCG of their power to give grants as well as contracts and the circumstances where it might be advantageous to do so.

4.3

Where there are restrictions or changes to future resources, discuss with civil society organisations the implications as soon as possible.

Ask the CCG to give regularly updates (through a sector representative or forum) of ongoing budget discussions.

5.2

Acknowledge that organisations representing specific disadvantaged or underrepresented groups can help promote social and community cohesion.

Work with the CCG to map the diversity of the local voluntary sector and show how links with specific organisations could help reach a wide range of ‘under the radar’ people and groups.

Embedding the Compact in your local community

Forty-seven per cent of respondents to the 2015 Annual Survey of Local Compacts said that their CCG is signed up to their local Compact, compared to 21% in the 2013 survey. The Department of Health’s statutory guidance also sets out the expectation that the relevant local Compact should be considered and recognised within the JSNA and JHWS process.

The following list provides some pointers on how to encourage good partnership working:

  • Encouraging explicit reference to the principles of the Compact in commissioning plans.
  • Establishing routes of communication between the CCG and the local Compact group.
  • Encouraging the CCG to sign up to the local Compact if they are not already – this can be part of a broader process of renewing a local Compact.
  • Don’t forget the other levers for good partnership working – in particular the public authority’s duties under the Public Services (Social Value) Act 2012 and the public sector equality duty under the Equality Act 2010.

 Examples of engagement with CCGs

 

Page last edited Mar 28, 2017

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