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Tough talk at the NAPC yesterday – and it wasn’t from Earl Howe

The more you provide, the less you commission, the NAPC annual conference was told yesterday.

The quote belongs to former primary care tsar, Dr David Colin-Thome and was used by NAPC executive member, Dr Nav Chana, as he introduced a new primary care innovation network.

In this presentation though there were some soft ‘jabs’ at primary care.

Conference was told by Dr Chana that we were still in a 1983 model of primary care provision.

His co-presenter, Dr Robert Varnam, asked whether general practice could ‘talk about outcomes and not how busy we are’ and asked where the ‘O’ had gone in QOF.

This ranking up the pressure on primary care was something of a theme running through yesterday.

Earl Howe, delivered his own tough talk on the GP contract negotiations and said while the government would seek agreement with the BMA it ‘would not back away’ from making changes which benefit patients.

The heavyweights delivering harder messages for GPs came yesterday morning when the Department of Heath’s commissioning network lead, Dr James Kingsland said the reforms were’ as much about change to primary care provision as to buying services differently.’

And Lord Victor Adebowale, didn’t pull his punches when speaking about GPs.

 ‘I have every respect for primary care and GPs but if you assume that the world revolves around the fact you are the cleverest people in the room, we are doomed.’

The pressure is definitely on for general practice to deliver on these reforms – perhaps not the best time for GP contract negotiations to break down.

 I wonder if there has been a cranking up of the primary care role as a result of how difficult it is proving in some areas to get traditional providers to react and adapt to the reforms, particularly as QIPP moves into the next stage requiring real transformational change.

There will doubtless be self-protection resistance by some acute trusts. But others are in serious financial trouble.

A report by MPs out yesterday shows one in five hospital trusts are in financial trouble and their situation is expected to get much worse when CCGs take over.

The doom laden report from the House of Commons Public Accounts Committee, warns that despite the NHS being in surplus in 2011/12 it conceals the ‘significant minority’ which are in financial difficulty.

Will this financial instability of trusts prove to be the ‘punch’ CCGs didn’t see coming?

Make and you don’t have to buy, could be a message that gets much louder over the coming months.

Sue McNulty is editor of Practical Commissioning

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