GP consortia ‘not about replicating current structures’, NHS chief executive warns

By Gareth Iacobucci

GP consortia will represent a 'fundamental change' to the structure of the NHS and must not become mere replicas of existing PCTs, NHS chief executive Sir David Nicholson has warned managers.

In a letter to PCT and SHA bosses, as well as other senior managers, Sir David said the proposals laid out in the NHS white paper would herald not only a rethink of the structure of the health service, but also of the ‘culture and ways of working' within it.

He also cautioned that GPs must not be rushed into joining consortia too quickly, and said practices needed to be given ‘time and space' to develop their plans.

‘I want to be clear that this is not a race to have the first or the most GP consortia established,' he wrote.

‘This is not about dragooning GPs into administrative boundaries that they do not feel any allegiance with. It is certainly not about replicating current structures with some new players involved. The proposals represent a fundamental change, not just in structure, but in culture and ways of working.'

Sir David added: 'PCTs should provide support for this process and empower consortia to take on new responsibilities quickly when they are ready to do so, but it is important that solutions develop from the bottom up and are not imposed from above.'

Sir David's warning follows disquiet from some GPs that consortia were being described in terms that made them appear too similar to PCTs.

The GPC's first detailed guidance to GPs on how to go about forming consortia, published last week, warned that organisations covering fewer than 500,000 people risk going bust.

But some GPs voiced concerns at the plans, which they said made consortia sound increasingly similar to existing PCTs.

Dr Philip Marriott, a GP in Crowborough, East Sussex, was one GP to voice concern at the proposals, which he warned sounded like ‘reinventing the wheel as usual'.

‘750,000 sounds larger than our starting PCT,' he said.

Sir David's letter also contains details of a management shake-up at SHA level, with a clutch of new managers appointed to lead the transition in implementing the white paper.

To read the full text of Sir David's letter to NHS managers, plus a series of related DH guidance documents, please click here.

A top line-up of expert speakers – including Andrew Lansley, Sir David Nicholson and Mark Britnell - will be addressing the latest developments in GP commissioning at the NAPC Annual Conference in Birmingham in October.

To find out more and book your place today please click here.