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Dr Michael Dixon: 'Some of the complexities of commissioning are not necessary'

Dr Michael Dixon looks at why some senior GP commissioners have become disillusioned with their commissioning powers

Read the original story here: One in three senior GP commissioners disillusioned with commissioning powers

In around half the cases it may be that GP chairs of CCGs have got to know the complexity of commissioning in terms of having to get buy-in from other people and the importance of having to ensure there are no conflicts of interest.

In a sense, some of the necessities of commissioning can seem quite weighty to someone that is relatively new to the world. You might go in thinking you can change everything in a second but realise it takes quite a lot of time.

For the other half, it may be that there are complexities of commissioning that are not necessary. We have been talking this week about the need to cover your back to make sure you have not been anti-competitive, for example.

Another issue might be the financial system at the moment and some bodies are so short of money, it’s quite difficult to frontload new services when you are closing down old ones. So the room for manoeuvre is much less than they had hoped in terms of wanting to reconfigure.

Also, they have spent a lot of their time doing authorisation. The health bill only got through less than a year ago, and they’re having to do a lot of clinical and corporate governance, and a lot of getting to know their local practices, clinicians and patients. So there is a hell of a lot of organisation going on, which is clearly not moving the wheels of commissioning. That might also be why some are disappointed - they simply haven’t had much time to do it.

Dr Mike Dixon is the chair of the NHS Alliance and interim president of NHS Clinical Commisioners

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