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'Imperative' CCG senior positions are filled by GPs, says Lansley

By Gareth Iacobucci | 01 Dec 2011

Clinical commissioning groups should appoint GPs to at least one of their senior leadership positions to avoid simply re-creating existing PCTs, health secretary Andrew Lansley has declared.

In a keynote speech at the NHS Alliance conference in Manchester yesterday, Mr Lansley said it was ‘imperative' that a clinician held ‘at least one of the CCG's senior leadership positions', and that accountable officers and chief financial officers both sat on CCG governing bodies.

However, the GPC responded by recommending GPs take the role of chair, rather than accountable officer, because of the lack of job security presented by the latter.

Mr Lansley told delegates: ‘There has been some confusion as to whether the most senior roles – like the accountable officer and the chair of the governing body – should be filled by clinicians or not.'

‘The whole point of clinical commissioning is to put clinicians at the heart of commissioning. I believe it is imperative that senior clinical leaders should hold at least one of the CCGs senior leadership positions.'

He added: ‘The accountable officer and the chief financial officer should also both be on the governing body, reflecting those challenges of improving clinical outcomes and ensuring the very best use of resources so that the key decisions and the decision makers cannot be alienated from the governing body and its responsibilities.'

GPC deputy chair Dr Richard Vautrey said the GPC supported GPs being in senior leadership roles on CCG, but warned that taking on the accountable officer positions may be more risky than being appointed chairs.

He said: ‘Whilst some GPs may want to take on the role of accountable officer, many would find that very difficult, and would be better taking the chair's role. They could then employ a chief executive type to fulfil that role.'

‘There are a number of big risks for GPs taking on the accountable officer role, not least when you look at the average lifespan of an NHS chief executive; less than two years. For a GP to become the accountable officer, and then to hope to be able to return to their practice should things not work out, it could potentially place them in a very difficult position.'

Mr Lansley also told delegates at the conference that the NHS Commissioning Board's job would not be to tell CCGs what to do, but to focus the majority of its energies on primary and specialised commissioning contracts.

The health secretary said: ‘The job of the NHS Commissioning Board is not to tell CCGs what to do or how to do it in the same way as nearly six years ago David Cameron and I said we ought to move to a NHS where we on behalf of the taxpayers are clear about what we are setting out to achieve, what are the objectives but we're not going to tell it day by day how to do it.'

READERS' COMMENTS

Anonymous, PCT,
01 Dec 2011
Dr Richard Vautrey said the GPC supported GPs being in senior leadership roles on CCG, but warned that taking on the accountable officer positions may be more risky than being appointed chairs.

Thats the whole point and why a GP needs to hold that position. If GP's have the majority on the Board then a GP should be accountable for the decisions that Board takes, not some poor manager who will have to carry the can if there is an adverse impact as a result of the Boards decision.

THe position is hardly risky for the GP. In the worst case scenario they go back to being a full time GP. If it is a manager they loose their job and all their income.
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Anonymous, PCT,
01 Dec 2011
Is Lansley finally admitting that the only difference between the new shining CCGs and the 'failed' PCTs is the top tier leadership???

Would have been slightly cheaper to hire GPs as the majority of PCT Directors (as many have suggested).

PCT Finance Manager
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Marie-Louise Irvine, GP Partner,
01 Dec 2011
I don't know how to vote for a post but if I did then I would have voted for you. This is a very good point. Very simple but very true!
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