NHS managers seize control of pathfinder consortia programme

By Gareth Iacobucci

Exclusive: NHS managers are setting strict targets for signing up GPs to pathfinder consortia amid concerns they are attempting to control the direction and accelerate the pace of the Government's reforms.

One SHA plans for all its GPs to be ‘pathfinders' by March 2012, a full year before the official handover to general practice, raising serious questions over whether GPs will get the chance to learn from early adopters, as had originally been intended.

GP leaders warned managers were desperate to push GPs into formal commissioning structures as soon as possible, because their own organisations were becoming too weak to exercise statutory duties.

Health secretary Andrew Lansley set up the pathfinder framework to allow trailblazing GPs to test out control of real budgets early, with the GPC welcoming the plan as a way of piloting the Government's commissioning reforms.

But evidence has emerged that SHAs are using the scheme as a mechanism to control how and when consortia are formed.

NHS South Central has set a target of 100% of GPs being ‘pathfinders' by March 2012, insisting six are already up and running in its region, and that it would recruit all remaining GPs to the programme as soon as possible.

The SHA's latest board minutes state: ‘It is intended over the next 18 months all emerging consortia will become pathfinders and the GP commissioning team has set a target of 50% by April 2011, 75% by September 2011 and 100% by end of March 2012.'

Elsewhere, NHS West Midlands has set a target of 10% coverage by groups meeting pathfinder criteria by April 2011, when Mr Lansley has said the first money will become available for forming consortia.

LMC leaders expressed concern GPs could be prematurely forced into a pathfinder programme designed for advanced commissioners.

Dr Nigel Watson, chair of the GPC's commissioning and service development sub-committee and chief executive of Wessex LMCs, said: ‘LMCs need to be very mindful in areas where trusts want to dictate the form, function, structure and size of consortia.

‘As PCTs are losing staff, some, particularly the smaller ones, are going to struggle to complete their statutory functions. There may be areas where they try and push commissioning responsibility to GPs more quickly.'

Dr Paul Roblin, chief executive of Berkshire, Buckinghamshire and Oxfordshire LMCs, warned: ‘There is a danger of plans being accelerated too much. It's up to LMCs to watch and be vigilant.'

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