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Analysis: ‘Competition regulations are a ticking time bomb’

Evidence of greater investment in LESs is welcome, but CCGs will struggle to justify this in future, says Dr James Kingsland

Evidence of greater investment in LESs is welcome, but the biggest ticking time bomb is that, from 1 April next year, GPs will not be the preferred provider.

This will put pressure on CCGs to do what they can to keep this funding with their member practices, without breaching competition regulations. They should be focusing on how it is deployed in their current member practices, but they will have to do it so that it doesn’t look as though it is a monopoly arrangement.

They have to come up with some sophisticated ways of saying: ‘Not only are we using the legacy LES money, but we are going to invest more.’ They will have to prove they are taking money from ineffective outpatient or urgent care services and are investing it in member practices.

A risk is that general practice is not well geared to go into a competitive market and we have got the independent and commercial sector coming in, [which are] much better skilled at bidding in competitive tendering procurement.

Another risk is that, if CCGs say LES funding has to go into their baselines to meet the current pressures in hospitals, I will be concerned about the future viability of the NHS as it is dependent on a strong primary care system.

Dr James Kingsland is national clinical lead for the NHS Integrated Clinical Commissioning Community and a GP in Wallasey, Merseyside

Readers' comments (3)

  • I can't see how we can enter into a competitive market unless we can set out own charges for services. A free market cannot function any other way!

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  • We should not need to do all these extra services just so we can run the practice. We should be funded adequately for doing the day job - which is seeing patients who are ill.

    If the government wants primary care to be strong it needs to fund it.

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  • Hmm it will be I suspect and this is an opinion the GP will be 'encouraged' to do all the work for free and to make the world a better place as it is a vocation ie les Just phrased differently and the private providers will get money for it and allowed to charge ....as for GP charging well we can see the backlash there

    This will lead not only to feelings of abuse and despair by the GP as they will find it difficult to offer the same degree of service due to lack of funding and infrastructure
    The GP will be fed the guilt card and vague innuendos of lack of care ie eg the over 75 named clinician will be names shamed and discarded and private companies will come in as 'saviours' as one says and will charge to look after etc etc but they will get the money to do it

    Competition rules great by it has to be a level playing field
    When you are dealing with multimillion pound companies does anyone really honestly believe the normal GP has the capital and business acumen of a Virgin care for example , R Branson Boots RC and his kind know a lot of politicians and buy in bulk so will always get a better deal always
    I maybe wrong but I can not see another realistic way , sure theoretically there are always options but realistically it's what I think as an opinion will be what happens
    But we all have to live in this changing times and adapt

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