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RCGP chair calls for ‘flexibility’ on commissioning deadlines

By Pulse news desk

GPs in some areas might not be ready to start commissioning by April 2013 and should not be forced into taking on budgets too early, RCGP chair Professor Steve Field has told Pulse.

Professor Field called for ‘flexibility' in applying the start date for commissioning, insisting he did not want to hold back those GPs who were ready, but warning others felt they could be ‘set up to fail' if made to begin too early.

His comments follow the release of an RCGP report detailing a consultation with its members on the commissioning plans, which found support for GPs' opportunities for leadership, but ‘major concerns' over the pace, scale and cost of change.

Professor Field said it would be important to monitor progress towards commissioning locally, to assess whether an area's GPs were ready to take on their share of the NHS budget.

‘Some areas might be slower than others,' he said. ‘We don't want some areas to be set up to fail because they haven't had the support and time they need.'

He said college members felt there had been a ‘bit of a vacuum' from the Department of Health since the release of the white paper, which had made it harder to prepare for the major changes ahead.

‘GPs wanted to make sure they could deliver and not be set up to fail. They wanted flexibility in timescale. We understand there needs to be a final deadline, but to start with some flexibility would send out the right message.'

He said there was an ‘overwhelming feeling that putting GPs in leadership positions was the right thing to do', and an enthusiasm for the idea of taking on commissioning, but also ‘concerns that need to be addressed'.

In particular there was ‘a lot of anxiety' that if GPs had to rush to form consortia, they could miss out on the best NHS managers, and a door might be opened for the private sector to provide commissioning support instead.

‘A lot of people felt that if there was lots of disruption and not the ability to evolve into commissioning then private companies might come in opportunistically. A number were worried by any willing provider,' he said.

‘A number of people felt in some areas PCTs were doing a very good job. If consortia were having to do everything PCTs are doing with much reduced management cost that would be difficult and could put them at risk of failing.'

Professor Field said commissioning needed to be done ‘collaboratively', through talks with specialists, other healthcare professionals and NHS managers. His comments came after Pulse revealed that the college was in talks with the Royal College of Physicians and Royal College of Psychiatrists over drawing up a joint set of guidelines to govern GP commissioning and the involvement of consultants.

A Department of Health spokesperson insisted GPs across the country were generally supportive of its proposals.

'In reality, [the RCGP's recent report] reflects the feedback we've had from engagement events across the country - most GPs are enthusiastic about the opportunities offered by the white paper, but many are also apprehensive,' she said.

'For this reason, we will ensure that detailed implementation issues are tackled during the course of transition, and we look forward to the RCGP's full response to the White Paper consultations.'

Countdown to commissioning… are you prepared?

The clock is ticking with just over two weeks to go until the end of the consultation on the health white paper, Liberating the NHS: commissioning for patients. Yet there is still a huge amount of uncertainty within the healthcare community, with questions being thrown up around the work and responsibilities that will be involved in the ‘new' NHS.

Come to the NAPC Annual Conference to hear from Andrew Lansley, secretary of state for health and help answer your pressing questions.

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