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King's Fund calls for NHS services to be outsourced to private firms

By Ian Quinn

The King's Fund has called for entire care pathways to be outsourced to external providers including private companies, claiming GPs do not have the time to make the required service re-design in primary care demanded by the NHS reforms.

The influential think tank says GP consortia should look to devolve responsibility under proposals which would see external providers offered financial rewards and take on the financial risks for developing NHS services.

It comes after Pulse revealed earlier this month that the Department of Health is backing plans for huge tranches of the health service to be put out for tender, with GP providers set to be pitted against private firms to take on care pathways, including services such as care for the frail and elderly, musculoskeletal services and respiratory care.

Dr Nick Goodwin, a senior fellow at the King's Fund, told a meeting of key NHS figures in Westminster that the task facing GP consortia in developing services in primary care was so huge it would be impossible for them to take on without outsourcing huge areas of care.

He said if busy GPs attempted to re-design pathways the job could account for ‘five per cent of the budget and 50% of the time'.

‘They will have to devolve responsibility to groups at a more regional level and they may well be external groups including private companies,' he said.

‘GPs can set the standards but consortia will ultimately want to commission organisations to take on the risk.'

Mr Goodwin admitted the proposals were ‘controversial' but said GPs would have no option but to look to external providers as the Government draws up plans for a 'series of rewards and penalties' to provide the financial incentive to consortia to reduce the cost and increase the quality of NHS care.

Earlier this week a major investigation by the King's Fund described the GP profession as a ‘cottage industry in need of modernisation'.

It said a change in mindset and culture was needed amongst GPs to encourage them to embrace change, with a shift from the role of gatekeeper to that of 'navigator' in the new world of GP commissioning.

Pulse reported earlier this month that NHS East of England is developing plans to put a raft of care pathways out to tender under the Government's any willing provider policy, while other areas, including NHS Oldham, are also planning competitive tenders which would be open to private firms to compete to take on primary care services.

A series of GP pathfinders and NHS Surrey are already working with a private company, Integrated Health Partners, on plans for a risk-sharing model whcih would see private firms take on service re-design and practice performance management in return for receiving financial incentives.

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