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At the heart of general practice since 1960

Can we talk?

Practical Commissioning editor Sue McNulty ponders how clinicians negotiate

Practical Commissioning editor Sue McNulty ponders how clinicians negotiate

Throw the managers out of the room and let the GPs and consultants work out the best way to provide patient care. Then allow the managers back into the room to work out how to share out the cash.

This scenario of effective pathway redesign has been quoted to me on at least two occasions by clinicians ahead of the commissioning game.

This might well work in rural areas where there's only one acute hospital but it's hardly opening up the market – though it is definitely clinically led.

And I heard today that the BMA wants to get consultants to be formally represented on consortia to ensure quality (or perhaps equality?) etc. I know the BMA's a union and needs to represent its members but it's getting itself into a muddle here.

If consultants are on the commissioning board there's a potential conflict of interest – not insurmountable as GP providers have been able to show but more likely a consultant is a provider than a GP.

A storm's brewing for the BMA with members asking if the negotiators should ever have had a sit down to discuss commissioning in the first place.

Interesting press release from the BMJ yesterday announcing acquisition of a UK software company which provides performance management tools for GPs. The press release goes on that the company has also developed a centralised performance tracking system for consortia and commissioning organisations. So now the BMA owns its own software commissioning tool. Dr Laurence Buckman welcomes the acquisition and is quoted saying so in the press release– but that commissioning software might well be left to gather dust on the shelf if some BMA members have anything to do with it.

Sue McNulty

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