1 May 2019updated 07 Jun 2021 2:29pm

A big problem for the NHS: reconciling local independence with central control

A woman holds a copy of the "The NHS Long Term Plan" booklet ahead of a speech by Britain's Prime Minister Theresa May launching the government's long-term plan for the National Health Service (NHS) at Alder Hey Children's Hospital in Liverpool on January 7, 2019. (Photo by Anthony Devlin / POOL / AFP) (Photo credit should read ANTHONY DEVLIN/AFP/Getty Images)

Clinical Commissioning Groups (CCGs) are statutory bodies established under Andrew Lansley’s 2012 Health and Social Care Act. There are around 200 of them in England (the devolved nations have different arrangements) and they assumed responsibility for the bulk of NHS services in their local areas in April 2013. Yet even though they have just marked their sixth birthday, there won’t have been much celebrating. CCGs are currently in their death throes.

There has been no new legislation underpinning the changes and CCGs will continue to exist in name until there is. But over the past couple of years, the structure of the English NHS has been quietly revamped and many CCG functions are being dispersed. The bewildering array of acronyms can make one’s eyes glaze over. We’re witnessing yet another chapter in the interminable struggle to reconcile local independence with central control, a dilemma that has dogged the NHS for three decades.