This site is intended for health professionals only

At the heart of general practice since 1960

CCGs may take five years to be successful, say commissioning leaders

CCGs may take up to five years to successfully engage GPs and bring about meaningful changes to their local health service, one of the country’s most senior GP commissioning leaders has warned.

Speaking at the Conservative party conference in Birmingham last week, Dr Johnny Marshall, interim partnership development director of NHS Clinical Commissioners (NHSCC), insisted that CCGs’ engagement with practices was ‘improving’ but acknowledged that in some areas it was ‘not good’.

He said that the NHS Commissioning Board should only partly authorise groups which were unable to demonstrate engagement, with the removal of conditions dependent on better local partnerships with GPs and other healthcare professionals.

Pulse recently revealed that some CCGs have struggled to engage member practices, with initial results from practice surveys showing many GPs feel frozen out of the decision-making by the new boards.

Dr Marshall, a former chair of the NAPC and GP in Wendover, Buckinghamshire, said: ‘Clinical leadership will successfully shape general practice. How long is that going to take? In some places it is happening already because they have been doing practice based commissioning for five or six years. If you are looking at the next five years, it is going to take that length of time for the majority of people to develop the necessary relationships and partnerships.’

‘You can’t just come in and stop people from referring, or challenge people. For many of us who have been involved in practice based commissioning it has taken that long to really get that bedded as the new culture of the organisation.’

Dr Marshall said the process would be slower for some as CCGs were ‘starting from a different position’ of little or no clinical engagement.

He said: ‘The reality is you can’t put a timetable and say you must all have a relationship by 1 April 2013. That is an unrealistic vision.’

‘The NHS Commissioning Board recognises that in some areas relationships are developing really well and in other areas they are not. It should be recognised if they do not have these relationships and form part of their conditions [of authorisation].

Dr Michael Dixon, interim president of NHSCC, chair of the NHS Alliance, and a GP in Cullompton, Devon, agreed: ‘It will take three to four years until we see total visible change in the organisational system. It takes time to turn a tanker around.’

‘I think there will be some low hanging fruit with some new commissioners that will be hitting the ground running while for others it will take longer.’

Click here to read the editorial: Building a new NHS will take time

Readers' comments (7)

  • Who wants to put money on CCGs existing in three years, let alone five????

    Unsuitable or offensive? Report this comment

  • CCG's will be lucky to get 2 years. The govt will have to show them as a sucess before the next general election.

    Unsuitable or offensive? Report this comment

  • Vinci Ho

    Another 5 years and another 5 ....
    'Tomorrow is another tomorrow , how many moe tomorrow have we got?' A Chinese saying......

    Unsuitable or offensive? Report this comment

  • Derzi centre anyone?

    Unsuitable or offensive? Report this comment

  • And we hear from one of the cheerleaders of the NHS reform, someone who apparently doesn't ever question anything the government has told him. The transition to CCGs has several purposes, none of which GPs like Dr Marshall have thought about at all (though he's terribly keen on advising other GPs as an "expert" on commissioning). They are:
    1. to manage the competitive markets which US hospital service providers have asked our MPs to be put in place so they can get a share of the secondary care funding stream.
    2. to make sure that the public see the reform as "for" GPs and therefore the moral responsibility as theirs. This scapegoating will be handy for MPs when the public gets very angry, which it will in a couple of years when it surveys the wreckage of the NHS.
    3. To be a transitional stage in the takeover of primary care by the US insurance companies. In the mature US health insurance market, they're not making much money any more, so they thought they'd persuade our politicians to let them create an emerging market for their services in England, by getting rid of our universal comprehensive health care system and replacing it with one based around individual accounts managed by statutory insurance schemes as in the USA. CCGs are those statutory insurance schemes (look at how they function to purchase referral care - that is an insurance model), and they are designed to smooth the transition from PCTs + GPs together running prinmary care to insurance companies taking on this role for profit, as they do in the USA and increasingly in mainland Europe (e.g.German, French and Dutch systems are all part-privatised now due to capture of political systems by commercial interests).
    For heaven's sake, could GPs please stop thinking that CCGs are a benign arrangement to empower them, or to help patients. LaLa had to tell you that to get you to go along with him, but by now surely you have grasped that a lot of things you were told have turned out not to be true. And we have a new SoSH who has gone into print to say he thinks the NHS should be dismantled.
    Wake up - CCGs are a key stage in the dismantling, and in the future you will rue the day you believed they were anything else, and regret that in your eagerness to trust MPs and the DH, you colluded with Lansley and Hunt in selling out the NHS to the US healthcare industry!

    Unsuitable or offensive? Report this comment

  • The purcahser provider split has had 20+ years to work and according to the Health Select Committee report on commissioing it has been a failure.
    The sooner we learn that market failure is inherent in healthcare delivery, the better. It is no coincidence that the vast majority of NHS reorganisations have occured since the introduction of the internal market. The market deosn't work, no matter how hard you tweak it.
    It is tragic that an entire generation of GPs doesn't know any different to the PP split.

    Unsuitable or offensive? Report this comment

  • I don't want to appear at all disrepectful to GPs but those that did not mouth opposition to the Tory/Lib Dem Head Nodders dismantlement of the NHS in England are going to rue the day. I agree with Anonymous at 09:40. GPs have been suckered and it is they that patients will be blaming for the wholesale marketisation of a NATIONAL Health Service in england. I already do blame my GP (Virgin/Assura).

    Unsuitable or offensive? Report this comment

Have your say