The new commissioning landscape

Arguably the area of the NHS in England most affected by the reforms is the commissioning system. The Department of Health defines commissioning as "the process of assessing the needs of a local population and putting in place services to meet those needs" (see Equity and excellence on the DH website).  Primary care trusts and strategic health authorities were formally abolished on 1 April 2013, and replaced by NHS England (previously known as the NHS Commissioning Board) and 211 clinical commissioning groups (CCGs).

On this page you will find more information about the new public bodies which will commission clinical care in England, and about the role of nurses in the new system. Please visit the public health reforms section for information on the changes to public health commissioning, and the HR transition process and workforce issues section for information on how the changes affect staff working in commissioning.

Many of the resources on this page are available in PDF format [see how to access PDF files]. Please note: NHS England was known as the NHS Commissioning Board until 1 April 2013, so some resources may use the organisation's original name.

Clinical commissioning groups

Under reforms of the Government's Health and Social Care Act 2012, clinical commissioning groups (CCGs) have taken over responsibility for commissioning the majority of NHS services in England. All 211 CCGs were authorised by NHS England before April 2013, some with conditions. CCGs are statutory public bodies, with powers and responsibilities set out in legislation.

RCN resources on CCGs:

External resources:

NHS England

NHS England (known as the NHS Commissioning Board until 1 April 2013) is a new national organisation which commissions some services, and holds CCGs to account for their use of public resources. It also ran the process of authorising CCGs. The board is an independent body, at arm's length to the Government but accountable to the Secretary of State for Health.

RCN resources on NHS England:

External resources:

Other groups

A number of other new types of organisations have been formed to support the new commissioning organisations. The RCN has developed fact sheets to help members understand how all these groups fit together.

External resources on commissioning

The following websites and documents provide further details on clinical commissioning activity. Please note that although these links are provided for reference, this does not indicate direct RCN endorsement for these information sources.

Get involved

The RCN is working to provide support and a range of development opportunities for nurses directly involved in the new commissioning organisations. If you are a lead nurse for a CCG and want to know more, please send your membership number and your contact details to commissioning@rcn.org.uk We will add you to our database and ensure you are kept up to date, supported and involved.