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GPs and consultants hold talks to defuse tension over commissioning plans

By Gareth Iacobucci

GP and consultant leaders are holding crunch talks in a bid to ease simmering tensions over the plans to shift the bulk of NHS commissioning budgets into GPs' hands.

The talks are aimed at building a consensus between the different factions and to thrash out guidelines to take forward the commissioning reforms

The talks follow reports of disquiet from senior hospital clinicians over GPs' abilities to commission some specialist areas such as mental health and oncology, with some warning that not all GP consortia would have the necessary skills to effectively commission services, and that consultants were being frozen out of the plans.

Pulse has learnt that the RCGP has scheduled a series of meetings with the Royal College of Physicians and the Royal College of Psychiatrists in a bid to smooth out tensions, with the groups planning to develop guidance and training packages for GP commissioners in the next six to nine months.

Professor Dinesh Bhugra, president of the Royal College of Psychiatrists and professor of mental health at the Institute of Psychiatry in London, told Pulse there were some ‘tensions' between GPs and mental health specialists on areas such as commissioning for patients with addictions.

He said: ‘There would be bits of tension on things like addictions because not every addiction problem is simple or can be treated, when there may not be great time or resources available in primary care.'

‘The areas of consensus are, for example, complex co-morbid conditions. We would be very happy to look after them, and GPs would be very happy for us to look after them.'

He added: ‘In the past, there have been difficulties with commissioners not understanding lots of mental health issues, and I think the challenge and the responsibility on us is to try and work with commissioners and educate.'

Dr Patrick Cadigan, registrar of the Royal College of Physicians, warned it was imperative that the reforms did not hinder cooperation between GPs and consultants.

He said: ‘The RCP is clear that a key practical test for the NHS reforms will be whether they support or hinder closer cooperation between primary and secondary care teams of the kind that is vital to managing an increasingly complex disease burden.'

‘Our initial reading of the White Paper is that it may present major opportunities for local physicians, working with primary care colleagues, to design pathways of care for patients that are efficient and economical, that reflect local resources, talents and geography, and where decisions about follow-up ratios, referral policies and discharge strategies are made by coalitions of clinicians.'

Dr Patrick Cadigan: 'Key test of reforms will be whether they foster or hinder cooperation' Dr Patrick Cadigan: 'Key test of reforms will be whether they foster or hinder cooperation' Countdown to commissioning... are you prepared?

The clock is ticking with just over two weeks to go until the end of the consultation on the health white paper, Liberating the NHS: commissioning for patients. Yet there is still a huge amount of uncertainty within the healthcare community, with questions being thrown up around the work and responsibilities that will be involved in the ‘new' NHS.

Come to the NAPC Annual Conference to hear from Andrew Lansley, secretary of state for health and help answer your pressing questions.

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