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Leadership for health commissioning in the new NHS : Exploring the early development of clinical commissioning groups in England

Anna Coleman (Centre for Primary Care, Institute of Population Health, Manchester University, Manchester, UK)
Julia Segar (Institute of Population Health, University of Manchester, Manchester, UK)
Kath Checkland (Institute of Population Health, University of Manchester, Manchester, UK)
Imelda McDermott (Institute of Population Health, University of Manchester, Manchester, UK)
Stephen Harrison (School of Community-Based Medicine, University of Manchester, Manchester, UK)
Stephen Peckham (Centre for Health Services Studies, University of Kent, Canterbury, UK)

Journal of Health Organization and Management

ISSN: 1477-7266

Article publication date: 16 March 2015

Abstract

Purpose

The purpose of this paper is to explore the early experiences of those involved with the development of Clinical Commissioning Groups (CCGs), examining how the aspiration towards a “clinically-led” system is being realised. The authors investigate emerging leadership approaches within CCGs in light of the criterion for authorisation that calls for “great leaders”.

Design/methodology/approach

Qualitative research was carried out in eight case studies (CCGs) across England over a nine-month period (September 2011 to May 2012) when CCGs were in their early development. The authors conducted a mix of interviews (with GPs and managers), observations (at CCG meetings) and examined associated documentation. Data were thematically analysed.

Findings

The authors found evidence of two identified approaches to leadership – positive deviancy and responsible guardianship – being undertaken by GPs and managers in the developing CCGs. Historical experiences and past ways of working appeared to be influencing current developments and a commonly emerging theme was a desire for the CCG to “do things differently” to the previous commissioning bodies. The authors discuss how the current reorganisation threatens the guardianship approach to leadership and question if the new systems being implemented to monitor CCGs’ performance may make it difficult for CCGs to retain creativity and innovation, and thus the ability to foster the positive deviant approach to leadership.

Originality/value

This is a large scale piece of qualitative research carried out as CCGs were beginning to develop. It provides insight into how leadership is developing in CCGs highlighting the complexity involved in these roles.

Keywords

Acknowledgements

The authors are grateful to the participants who were very generous in allowing us access to their organisations at a time of considerable turmoil and change. The authors are also grateful to Rosalind Miller, Christina Petsoulas and Andrew Wallace for their hard work during the data collection.

Citation

Coleman, A., Segar, J., Checkland, K., McDermott, I., Harrison, S. and Peckham, S. (2015), "Leadership for health commissioning in the new NHS : Exploring the early development of clinical commissioning groups in England", Journal of Health Organization and Management, Vol. 29 No. 1, pp. 75-91. https://doi.org/10.1108/JHOM-04-2013-0075

Publisher

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Emerald Group Publishing Limited

Copyright © 2015, Emerald Group Publishing Limited