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Tories reveal plans to shake up commissioning

By Gareth Iacobucci

GPs would be free to commission services from neighbouring PCTs under Conservative plans to beef up practice-based commissioning.

The proposals, unveiled by shadow health secretary Andrew Lansley, would allow practices to source services from elsewhere if there was nothing within their own trust's borders that met their patients' needs.

But the plans have provoked controversy, with GPs warning they could undermine attempts by PCTs and local authorities to work together on joint commissioning of health and social services.

Mr Lansley told delegates last week's World Class Commissioning conference in London: ‘If a group of practices with a commissioning budget want to outsource to another PCT, we should have that.'

He also acknowledged some GPs were anxious about the party's plan to hand full commissioning responsibility back to the frontline, admitting up to a third might not want to directly commission services.

He said in these cases, GPs would maintain overall responsibility, but could delegate commissioning decisions to their own PCT, neighbouring trusts or private firms such as UnitedHealth, Bupa and Humana.

‘GPs get anxious and say it's not my job to judge priority of resources,' he said. ‘Fine. Those that don't want to can ask others to do it on their behalf.'

Dr David Jenner, co-clinical PBC lead for the NHS Alliance, said cross-border commissioning might be impractical: ‘It's nice in principle but I can't quite see how it will work. The main stumbling blocks are responsibility for a registered list, health, overview and scrutiny panels and joint commissioning with social services.'

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