By Ian Quinn
The Department of Health is set to scrap the nationwide network of Darzi centres set up under the previous government, after ordering a review of all GP-led health centre contracts in England.
A letter from GP commissioning tsar Dame Barbara Hakin revealed the new NHS Commissioning Board is to re-evaluate all GP-led health centre contracts when they expire. The board will be given the option of recommissioning the centres without a walk-in element, as list-based practices, but will also look at making arrangements to transfer patients to other nearby practices.
Recommissioning the 'open access' element of Darzi centres, meanwhile, will be left up to GP consortia, in what will be seen as a major victory for the BMA and other opponent of Darzi centres, who have long argued they are a waste of money and duplicate established services.
The DH has also allayed fears that consortia could be lumbered with expensive GP-led health centre contracts which, as Pulse has reported, have contributed in some areas to huge PCT financial shortfalls.
The DH has also ordered a review of the 100 new GP practices for underdoctored areas which were set up across 50 PCTs by the previous Government as part of its equitable access scheme.
Dame Barbara's letter reveals the NHS Commissioning Board will take over the responsibility for GP-led health centre contracts from April 2013 at the latest.
‘In other words, GP consortia would not inherit the contractual liabilities for these services,' she said.
'In the run?up to contract expiry, we would envisage that the board would evaluate the case for re?commissioning list?based services for registered patients (or, alternatively, make arrangements for registered patients to transfer to other GP practices), whilst GP consortia would decide whether to re?commission the ‘open access' element – or any other element – of the service.'
Dame Barbara's letter also sets out details of additional funding for the APMS practices provided to underdoctored areas. PCTs will receive ‘non?recurrent' additions to their baseline for 2011/12 of £1.1m for each new practice that is open to new patient registrations as of April 2011.
Where a practice has been commissioned but has yet to open, pro?rata funding will be allocated following the opening of the practice.
But the DH has also ordered PCTs to provide a quarterly report setting out details of the growth of the practices, including ‘any issues of concern about the new provision that has been commissioned'.
In a further twist, some GP-led health centres could be handed to PCTs and emerging GP consortia much earlier than 2013, with the Government indicating that those with no registered patients, or very small registered lists, ‘might more appropriately be transferred to other primary care providers, so that responsibility for commissioning the ‘open access' service could be transferred to GP consortia.'
It adds: ‘This might be an appropriate option where PCTs and emerging consortia have plans to convert the service into part of their 24/7 urgent care arrangements.'
GP leaders have long been calling for Darzi centres to be scrapped and funding redistributed to other practices.
Last month Pulse revealed the legacy of the GP-led centre network of Darzi centres had left some PCTs facing financial shortfalls of up to £300,000 a year.
NHS Bromley blamed its entire primary care budget deficit, tipped to reach £290,000 by April, on its GP-led health centre contract, while NHS Haringey, which revealed in November that both of its Darzi centres were set to close, claimed they had cost a combined £666,000 a year.Darzi centre contracts across the country are to be reviewed when they expire