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Buckman sparks confusion over GPC stance on CCG size

GPC chair Dr Laurence Buckman has prompted confusion over the GPC's stance on how CCGs should form after flagging concerns that groups are being pushed to become ‘remarkably like PCT clusters'.

This comes just a month after Dr Buckman wrote to the profession announcing a shift in the GPC's policy, advising CCGs to ‘be proactive and come together to form a CCG of PCT or even PCT cluster size.'

But in a wide ranging interview with Pulse, in which the GPC chair also addressed pensions, revalidation and contract negotiations,  Dr Buckman said that the GPC recommended that CCGs formed larger groups for economic reasons but ‘not as large as they're now appearing to be'.

In the interview, Dr Buckman told Pulse: ‘As far as the NHS changes are concerned, I think the idea of GP commissioning, or clinically-led commissioning, is actually something that I think many GPs find quite attractive, I do. Unfortunately it's looking more and more like CCGS are getting pushed into bigger and bigger groups. We wanted them in larger groups for economic reasons but not as large as they're now appearing to be.

‘These larger groups appear to be remarkably like PCT clusters, the PCT clusters are going to be privatised, the services they offer to the caring bit of the NHS are going to be subbed out. So we will end up with NHS managers employed by the private sector selling their services back to the NHS to deliver what? Pretty much what we're offering now. ‘

In December Dr Buckman wrote to GPs to urge them to be ‘proactive' and form a CCG of the size of PCTs or PCT clusters. The large CCG should be underpinned by local ‘sub groups' he said. Previously the GPC had advised that CCGS should have a minimum population of 500,000.

‘In light of the current proposals, we are now recommending that CCGs should be proactive and come together to form a CCG of PCT or even PCT cluster size. It would be big enough to employ its own staff with the necessary skills and expertise to be an effective commissioning body,' Dr Buckman wrote.

‘This would not be re-creating a PCT, but would be a group led by clinicians who would ensure the smaller sub-groups were really empowered and enabled to take account local needs,' he added.

The need for large ‘super CCGs' was echoed by RCGP chair Dr Clare Gerada and Dr Richard Vautrey, GPC deputy chair, at a commissioning roundtable debate held by Pulse in December. At the time Dr Gerada said CCGs with a population of ‘one to five million…is the only way' forward.

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