By Ian Quinn
The Government is to grant huge powers to the NHS Commissioning Board, allowing it to help determine the shape and structure of GP consortia, and parachute in alternative providers, such as private companies, to help run those that are failing.
The health bill lays the foundation for the new board to step in and shut down consortia which have ‘failed to discharge any of [their] functions' or if ‘there is a significant risk that a commissioning consortium will fail to do so'.
The board - headed up by current NHS chief executive Sir David Nicholson - will also be able to intervene to change the size of a consortium, parachute in ‘any person who is a provider of medical services' to help run it, or remove any member of the consortium's management, if it is found to be failing.
The bill, which requires all GPs to be part of a consortium, also says the board will be able to make payments at the end of each financial year to consortia which ‘perform well', by either improving health outcomes or saving money, including the power to make ‘one or more' advanced payments during the year.
However, the board will also have the power to withhold money at the end of the year if advanced payments are made but consortia fail to hit their targets.
Every consortium will be made to prepare a plan at the beginning of each year, setting out how it plans to hit health and financial targets, which must be agreed with new Health and Wellbeing Boards, giving a powerful role for local authorities. Consortia must also prove they have consulted with their patients.
The bill says the board will be able to provide financial assistance to struggling consortia, despite health secretary Andrew Lansley's pledge that there will be ‘no bailouts'. Consortia will also be given powers to merge in the future.
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Sir David Nicholson
