Commissioning England Wales

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What is co-commissioning?

Co-commissioning refers to the process whereby CCGs can directly commission primary medical services and performance manage practices but not individuals.



How does co-commissioning work?

This was first introduced in November 2014 in the document 'Next steps towards primary care co-commissioning' for CCGs to take up from April 2015. NHS England offered each CCG the opportunity to adopt one of three commissioning models:

  • Model A: Greater involvement
  • Model B: Joint commissioning
  • Model C: Delegated commissioning

In the first year 63 CCGs took on full delegation, with another 51 CCGs opting for it the following year. The list of CCGs and details of which co-commissioning model they are using is available here.

At present, CCGs are not obliged to apply for any of the co-commissioning models and can continue to operate under existing arrangements.

CCGs will not have any additional powers over the commissioning of dental, community pharmacy and eye health.

See NHS England webpage on co-commissioning for supporting documents and details of how CCGs apply


What is the purpose of co-commissioning?

Co-commissioning aims to support the development of out-of-hospital services based around the needs of local people. Suggested benefits are:

  • Improved access to primary care and wider out-of-hospitals services with more services available closer to home.
  • High quality out-of-hospital care.
  • Improved health outcomes, better access to services and reduced health inequalities.
  • A better patient experience through more joined up services.


What is the BMA doing?

GPC has recently updated their guidance on co-commissioning to reflect the changing policy landscape as well as learnings from the areas that have already opted for delegated commissioning.

The guidance is designed to inform GP practices and LMCs about co-commissioning of general practice, and to make practices aware of their rights, as members of CCGs, to democratically influence the decisions of CCGs.

Download the GPC guidance on co-commissioning

GPC has also prepared guidance to help GP practices and LMCs interpret NHS England’s Statutory Guidance on managing conflicts of interest under co-commissioning. The GPC guidance also contains model wording covering GP contract and performance management that can be inserted into CCG constitutions.

View the GPC guidance on conflicts of interest