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BMA calls leadership elections in GP consortia across country

By Ian Quinn

Exclusive: LMCs in England have been told to start organising leadership contests immediately to decide who will head up local commissioning consortia.

The GPC warned that the handover from PCTs was a legal minefield, particularly the area of democratic legitimacy, and insisted in new guidance that fledgling consortia must secure the democratic backing of all GPs. It also warned the election process should address conflicts of interest, ‘both real and perceived' and include powers of recall so leaders could be deposed should they ‘lose touch' with grassroots GPs.

A Pulse investigation revealed last month that as many as one GP in four had an interest in a local private provider of NHS services, intensifying concerns over conflict of interest.

The GPC document states: ‘It would be useful to consider whether some conflict of interest would be so severe as to prohibit someone from taking part in decisions.'

It adds that neighbouring LMCs might need to run elections where they were complicated by local conflict of interest and that there would need to be a publicity campaign to ensure wide involvement.

Dr Chaand Nagpaul, GPC lead on commissioning, said: ‘All GPs must have a chance to be involved so it is democratic. It will be vital to get the right skill mix and qualities of GP leadership, but we also have to tackle conflict of interest.'

Dr Nigel Watson, chief executive of Wessex LMCs and GPC member, emphasised the need for urgency: ‘There is a risk that unless LMCs run these elections, PCTs will just decide that they will appoint clinical leads to run consortia by default.'

Dr Richard Van Mellaerts, a GP in Kingston, site of one of the first pathfinder projects, said an election would be held to decide the make-up of the shadow commissioning board within weeks: ‘It's important these bodies are in place quickly and are democratically accountable. The last thing we need is fisticuffs between the LMC, commissioning groups and the PEC about who runs what.'

He said all practices in the area would be invited to have a representative on a wider commissioning body, which would then elect a smaller board.

The GPC guidance also states LMCs must draw up fixed terms for shadow consortia, with new elections for commissioning proper to come in 2013.

Dr Chaand Nagpaul: 'The success of this entire transition will depend upon consortia having the democratic support of their colleagues' Dr Chaand Nagpaul: 'The success of this entire transition will depend upon consortia having the democratic support of their colleagues' Leadership elections

• LMCs to run elections across England for shadow consortia leadership.

• Neighbouring PCTs to run elections in areas where potential conflict of interest of candidates.

• Major publicity campaign to seek nominations to be launched.

• Potential bar from GPs standing for management roles if they have conflict of interest.

• Power of recall if leadership loses touch with electorate.

• Shadow consortia to have fixed term, with second elections lined up for 2013.

Source: GPC guidance

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