Primary care co-commissioning: challenges faced by clinical commissioning groups in England

The English Health and Social Care Act 2012 gave GP-led Clinical Commissioning Groups (CCGs) responsibility for commissioning the majority of health care services for their registered population. However, responsibility for commissioning primary care services was given to a new national body, NHS England (NHSE)(1), to avoid conflicts of interest(1) and because of a perceived need for a standardised and consistent approach to commissioning(2). It soon became apparent that NHSE was struggling to move beyond a transactional approach to commissioning, focused upon payments and contract management. When Simon Stevens took over as the Chief Executive of NHSE (April 2014), he advocated transferring responsibility for commissioning primary care services from NHSE to CCGs. Two years on, how have CCGs responded to their new responsibilities and what challenges do they face?