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GPs face legal challenge over PBC conflict-of-interest fears

By Steve Nowottny

GPs at the forefront of practice-based commissioning could be taken to court by private providers over conflict-of-interest claims, senior NHS managers warned yesterday.

The warnings come as the Government announced a new package of measures designed to ensure ‘a fair playing field' in procurement and commissioning.

Mike Farrar, chief executive of NHS North West, said GPs should expect to face legal challenges over the way in which services are commissioned.

Speaking at the All Party Parliamentary Group on Primary Care and Public Health's access inquiry, he told MPs: ‘If the Government is willing to bring in private providers… there will start to be challenges to the way the system rules operate. At the moment this is a completely unregulated area.'

Andrew Ridley, Director of Primary & Community Care Commissioning at Tower Hamlets PCT, claimed ‘real tensions exist'.

‘I do think there is a risk as new market entrants come in that we'll get challenged – or that we'll get challenged by patients,' he added.

Meanwhile the NHS Operating Framework for 2008/9, launched yesterday by NHS chief executive David Nicholson, has included new guidance on fairness in commissioning.

It contains a set of ‘clear principles and simple rules governing cooperation and competition for commissioners and providers to apply consistently to all those that provide services on behalf of the NHS, including social enterprise and third sector organisations, as well as the independent sector.'

The Department of Health will also set up an ‘independent sector procurement forum', which will allow private providers to advise it on ensuring a ‘fair playing field'. A competition panel, to provide ‘independent advice on competition issues to SHAs', will be set up by April 2008.

But GPC chair Dr Laurence Buckman, also giving evidence to MPs yesterday, played down conflict-of-interest fears.

‘I wouldn't be allowed to commission from myself,' he said. ‘I could end up being commissioned, but that would be from my cluster, who would include a variety of other people and then there would be the PCT.'

‘It would be difficult to corruptly and inappropriately offer a service.'

Dr Laurence Buckman: GPC chair says corruption fears are unfounded Dr Laurence Buckman: GPC chair says corruption fears are unfounded Opearting Framework: Key priorities

Improving access at eve-nings and weekends to GP services
- PCTs to ensure that at least 50% of GP practices offer extended opening
- During 2008/09, all PCTs to complete procurements for new GP led-health centres
- 38 PCTs with greatest need will receive addi-tional funding procure 100 new GP practices
- PCTs to work with GPs to improve patient satis-faction, including access to a GP within 48 hours and the ability to book advance appointments.

World Class Commissioning
- PCTs assessed by 10-15 health improvement tar-gets, which relate to re-ducing health inequalities.
- SHAs to manage an ‘as-surance system' to moni-tor PCT performance on health outcomes, compe-tencies and governance.
- PCTs must ensure that PBC succeeds by ensuring that practices have fair share of budgets, plus ac-curate and timely infor-mation on referrals and budgets.

Private and third sector
- Government to continue encouraging private sector provision where it will provide value for money and ‘meet patients needs'
- Strengthening commis-sioning capacity of PCTs via FESC.
- An independent sector procurement forum, which will allow private companies to advise the Department of Health on ‘policies and practices re-lated to local procurement of clinical services', in or-der to ensure ‘a fair play-ing field'.

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