NHS England legal directions

The legal directions on the CCG, implemented by NHS England in December 2017, were lifted in July 2019.

Following the latest annual national review of CCG performance (NHS England July 2019), the CCG’s position remains a rating of ‘requires improvement’.

Although we know this means we have a lot more work to do, we have been able to demonstrate progress in a number of areas that were a challenge to us as a CCG and, therefore, put the Island health and care system under greater pressure, too.

As a result of the progress we have made, NHS England and NHS Improvement have now written to the CCG to say that due to this continued improvement, the legal directions that were applied to the CCG in 2017 have now been lifted.

The directions focused on the completion of a whole system clinical and financial sustainability review and the production of a sustainability action plan to implement the recommendations made.

The CCG has now been able to meet these requirements and this has been in no small part due to the support we have received from our partners and stakeholders during this time.

We really do appreciate the efforts made by so many organisations and individuals to work with us in such a positive and proactive way over the past 18 months.                                               

The sustainability plan very much reflects the positive, and formal, shared working arrangements in place between the CCG, the Trust and the Council but we all fully recognise that there are many of our partners, colleagues and patient groups who will continue to have a vital role to play as we work our way through this

The hard work doesn’t stop here and so we look forward to developing even closer working relationships as we seek to make further improvement over the next 12 months in continuing to transform health and care services on the Island.

The requirements of the CCG from the directions process (December 2017)

The Isle of Wight Clinical Commissioning Group (CCG) was issued with legal directions by NHS England in December 2017, under powers conferred by the NHS Act 2006.

The directions focused on 2 key areas:

  • the commissioning of a Capability and Capacity Review and
  • the production of a clinical and financial sustainability plan.

In addition the Directions require the CCG to inform NHS England of the need to make any senior appointments to the executive team or the next tier of management. Appointments cannot be made without prior approval.

At its Governing Body meeting in December 2017 the CCG recognised the importance of meeting the requirements of the directions, identifying them as constructive and supporting the previously agreed position of the Governing Body.

The recognition of the scale of the transformation decisions that needed to be made was welcomed by the CCG, given that the additional scrutiny would ensure that the best decisions would be made for the health and care of people on the Isle of Wight.