GP commissioners should be delegated responsibility for commissioning primary care and are already exploring ways they can drive up quality in their colleague's practices, the Government's commissioning tsar Dame Barbara Hakin has told Pulse.
In an exclusive interview, Dame Barbara backed the proposal mooted by NHS Future Forum chair Professor Steve Field earlier this week that clinical commissioning groups should be delegated responsibility for commissioning primary care from the NHS Commissioning Board.
And she revealed that some fledgling CCGs around the country were already planning how they could extend their influence over primary care.
Dame Barbara said: ‘CCGs have got an enormous role to play in driving up quality in primary care and the [NHS Commissioning] Board will want to ensure that they do that. We have got places around the country starting to look at how that might be done. However we do that, we will have to ensure that it is done properly, openly and transparently to ensure there isn't a conflict of interest.'
She added: ‘It is a clear objective that CCGs will assist the board in developing improvements in primary care and my gut feeling is that there are some elements of primary care commissioning that could be delegated form the board to the CCGs.'
Dame Barbara also sought to reassure GPs that their relationship with patients would not be damaged by them being seen as rationers of care. Earlier this week a legal advisor to the Department of Health warned expensive legal bills could ‘kill' CCGs if patients challenge rationing decisions.
‘CCGs will have the same responsibilities to deliver all aspects of care that PCTs have had and if CCGs fail to do that they will be vulnerable to judicial review, but I think that some people are making more of this,' Dame Barbara said.
‘I think the relationship between GP and patient is such that GPs will always do the best for the patient in front of them. What we are looking for is not to deny the treatment they are looking for but to ensure they get the right treatment and sometimes the right treatment can be more cost effective than other treatments.'
‘I do recognise the fear of GPs that patients may perceive them as rationing care but I think it is up to the CCG to protect the individual practioner. They will have to draw up a clear framework of rules, which is generally what PCTs do so that any necessary treatment has to be delivered and GPs will have to do that.'
