Since our last newsletter we've had the reforms to the reforms and the first partial recommittal of a bill since 1951. The amended health bill 'treats GPs like children' according to the NHS Alliance, while Dr Hamish Meldrum told the recent BMA Annual Representative Meeting that the bill 'was on a better track' and did some back-patting on the changes that had been achieved.

Dr Brian Fisher, chair of the Socialist Health Association, says 'we are now out of a car crash and stuck in a traffic jam'. In a piece for Practical Commissioning, he advocates a new model for commissioners to consider – cooperative commissioning – that would make hospitals and GPs work together to achieve savings and drive up quality. Tim Jones of WG Consulting steps back and suggests how we might introduce new levers for commissioners and providers.

We now also have some numbers to crunch on how many staff will be employed by the new NHS Commissioning Board thanks to a leaked paper. My back of a fag packet calculation is that we could be looking at 10 NHSCB staff per clinical commissioning group.

Perhaps the new staff could help our GP commissioner at the coalface with some of the problems he's facing back at the practice that need sorting if GPs are to get on with commissioning.

We report from this week's NHS Confederation conference where Andrew Lansley was in the hot-seat before NHS managers, and GPC negotiator Chaand Nagpaul said commissioning will only work if it connects with all grassroot GPs.

Finally we have a new look website to make it easier for you to access case studies featured in Practical Commissioning and keep you up to date with all that's happening with commissioning. Let us know what you think of it.

Have a good fortnight.

Sue McNulty
Editor, Practical Commissioning

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