Increasing pressure on primary care means that many GPs will find it hard to find the time take part in clinical commissioning, according to a new study.
The Open University research, which was funded through the National Institute for Health Research Health Services and Delivery Research Programme, drew on data from previous service redesign attempts in sexual health services and dementia in a bid to identify what will be needed for clinicians to be able to deliver the Government’s clinical commissioning reforms.
The researchers interviewed a total of 74 people working across four different examples of service redesign, including hospital consultants, junior doctors, nurses, other clinicians, managers and commissioners. The interviews were supplemented with a series of observations from meetings.
The report concluded that clinicians who did demonstrate leadership were capable of being open to new ideas and new knowledge while also having the political wisdom to carry their colleagues with them.
However, in all but one of the case studies, the clinicians and managers behind the creation of new service models felt it had been difficult to involve GPs, with the researchers concluding that clinical leadership came largely from the hospital sector.
They said the findings would have implications for CCGs as they prepare to take chargeof the largest part of the NHS budget from April.
The report said: ‘Collaboration between primary care and initiatives in the acute sector appears particularly difficult, apparently because of the pressure on primary care over the last few years and difficulties for GPs in finding the opportunity to take part in wider initiatives.’
Dr Richard Holti, a co-researcher on the project, said: ‘Formal project planning is not enough; rather, informal, lateral leadership is important. This is needed in order to bring along clinical colleagues, to reassure them and to win their cooperation and ideas. The most effective service redesigns were achieved when both of these processes worked in tandem.’
The research was carried out over the past twelve months, during which the coalition Government’s health reforms became law.
It comes as GPC deputy chair Dr Richard Vautrey warned last week that CCGs will struggle because GPs do not have time to engage in clinical commissioning.
