Commissioning England Wales

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Checklist for CCG constitutions

A good clinical commissioning group (CCG) constitution should include a clear definition of how membership of the CCG is defined, who is eligible for membership, the application process by which practices can become a member of the CCG and the process by which membership of the CCG can be terminated, including an appeals process.

You should use the checklist below to ensure that your local CCG constitution is appropriate. We have listed the essential elements - it is not a comprehensive list as there may be local issues which you will also need to consider. 

The CCG constitution should include details of:


  • The CCG's name
  • A list of its members
  • The geographical area it covers
  • The start date of the constitution and its duration
  • How the constitution can be amended
  • Definitions of specific terms used in the constitution (eg 'member', 'observer', 'board' and other relevant terms)


Internal structures and operation

  • The elected board
  • The audit committee
  • The remuneration committee
  • Local or other devolved structures
  • The governance body, if different from the elected board
  • How the body will relate to and work with external organisations such as NHS England, the local Health and Wellbeing Board and the Local Medical Committee


CCG committees and bodies

  • Membership of committees, distinguishing between voting members and observers
  • Election and appointment processes
  • Roles and responsibilities
  • How it will operate (eg frequency of meetings, quorum, how decisions will be audited)


Governance systems

  • How member practices can hold the CCG to account
  • The roles and responsibilities of the audit committee and details of financial audit processes
  • Clear guidance on declaration and handling of conflicts of interest, particularly with relation to the elected officials of the CCG
  • How remuneration will be determined for work undertaken for a CCG by GPs and practices
  • Dispute processes if a dispute arises between member practices and the CCG
  • The role and responsibilities of the chair of the board, accountable officer and chief finance officer
  • Details of external bodies to whom the CCG will be accountable (eg NHS England, Health and Wellbeing Boards, HealthWatch)


Electoral and appointment processes

  • The posts for which elections will be necessary and terms of office
  • Electoral timetable and processes
  • Who can stand for and vote in elections
  • The screening process for required competencies
  • How elected officers of the CCG can be held accountable, and if necessary, removed from their post


Member practices, local GPs and the CCG

  • Details of the terms of engagement between practices and the CCG
  • A commitment from the CCG to communicate decisions and developments to all GPs in a timely fashion
  • How the CCG will seek the views of member practices and the local GP profession, including non-partner GPs