Talks between GP groups fail to bring consensus over commissioning plans

By Ian Quinn

Frantic behind-the-scenes talks are being held between national GP groups in a seemingly impossible bid to reach some consensus over the Government's plans for commissioning.

Organisations including the RCGP, the NHS Alliance, the National Association for Primary Care and the Family Doctor Association have been meeting to try to thrash out common ground, as the Government consultation on the plans splits the profession.

However there are huge differences to resolve, with some senior NHS Alliance figures now calling for the Government to shelve its plans to scrap all PCTs by April 2013, claiming that some trusts should be allowed to remain in place, if not permanently, at least until GP commissioning groups have proved themselves capable of taking over.

The NAPC has blasted the suggestion, arguing that with every day that goes by, tens of millions of pounds of NHS money is being wasted and urging the Government not to dilute its plans.

NHS Alliance leaders have been trying to convince other GP groups that the Government's plans are overambitious and that it should instead launch a series of pilot schemes in areas where GP commissioning is the most advanced.

The RCGP and the Alliance yesterday launched a major consultation exercise with GPs to gauge grassroots opinion, with plans for a joint submission to the official Government consultation, which ends in October.

NHS Alliance GMS lead Dr David Jenner said talks between the various GP factions had found much common ground, with broad support for the general direction of travel of commissioning. But major differences remain over the timescale and extent of the changes, including the plans to cull PCTs.

‘A string of senior health academics and organisations like the Nuffield Trust have expressed fears that to make such huge changes to the health service at such a time of economic uncertainty is an extremely risky policy,' he said. ‘The NHS Alliance's position is that the implementation should be phased.'

‘My personal view is that we may need to keep PCTs around a little longer.'

Dr Jenner said he believed in areas where GP practice consortiums were less advanced, PCTs should be allowed to remain in operation for longer to allow a ‘managed transition' .

He said: ‘Pulse's investigation this week on the situation with PBC shows how GPs in different PCTs are in very different places. There is huge variation. There are two different policies emerging: one to say let's phase the rollout and another to say let's set a date and go for it.'

However NAPC president Dr James Kingsland said he had ‘no sympathy whatsoever' with the call to pilot the plans.

‘2013 is long enough for us to wait,' he said. 'Some PCTs are rapidly starting to change already and in some cases dismantle and I would expect that many PCTs would be ready for the transition long before then.'

‘We simply can't afford to wait.'

Yet a poll on the NAPC website shows nearly 60% of its members are opposed to the Government's commissioning plans.

Dr Kingsland said: ‘This reflects the reality that there are some people absolutely in line with the reforms such as me and others, who strongly oppose them, including, I suspect, PCT chief executives.'

He added: ‘The only thing that frightens me is if the Government is persuaded to dilute its plans and we come up with another initiative that resembles PBC.'

The GPC, which has not been involved in the current talks, is set to lead negotiations on planned changes to the GP contract in the autumn.

The RCGP and NHS Alliance are holding a series of regional talks to discuss the Government's White Paper, aiming to give frontline clinicians and managers the opportunity to provide their feedback.

The workshops will culminate with a national feedback report – Putting GP Commissioning into Practice – which will be submitted to the Department of Health before the consultation period closes on 11 October.

The dates of the workshops are as follows:

9 September - Prospero House, 241 Borough High Street, London, SE1 1GA
14 September - Wetherby Racecourse, York Road, Wetherby, West Yorkshire LS22 5EJ
29 September - Leicester Racecourse, Oadby, Leicester
5 October - Newbury Racecourse, Newbury, Berkshire, RG14 7NZ

For more details go to www.medman.co.uk (Medical Management Services UK) or call 01225 333 711.

A top line-up of expert speakers – including Sir David Nicholson, Mark Britnell and Stephen Dorrell MP - will be addressing the latest developments in GP commissioning at the NAPC Annual Conference in Birmingham in October.

To find out more and book your place today please click here.