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AQP could push up costs, warns commissioning leader

A Government move to ramp up NHS competition by extending Any Qualified Provider could undermine GP commissioning and is likely to push up costs, a influential GP commissioning leader has warned.

Dr Mike Dixon, chair of the NHS Alliance told Practical Commissioning that the ‘diktat’ to force commissioners to employ Any Qualified Provider for a range of community and mental health services by September 2012 would tie GP commissioners hands.

The surprise move, announced last month, will require all clinical commissioning groups and PCOs to select three services for competition through Any Qualified Provider from a list worth an estimated £1billion including musculoskeletal services for back pain, adult hearing services in the community, wheelchair services for children, and primary care psychological therapies for adults.

The move followed recent amendments to the health bill – including an assurance that Any Qualified Provider would only be available for services with a national or local tariff – which appeared to reduce the role of competition in the governments reforms package.

Department of Health guidance on the new arrangements said currencies, information models and tariffs for the services would be developed by PCTs by November 2011.

Dr Dixon said: ‘OK if the government wants to get the ball rolling on Any Qualified Provider, I haven´t got any theological opposition to it in principle, but this is not how one would like things to work. We can´t have areas where competition will work centrally dictated. Local needs will vary.’

He added: ‘This is exactly the sort of thing we don´t need at the moment, stuff like this coming from on high. If we mean local let´s act local. This is diametrically opposed to the spirit of the refoms which we´re supposed to be about freeing GPs up to choose what best for their patients.

‘I´m not anti-competition, but this means I might get providers from outside, who are not local players within the need to contain costs. Their aims might be quite the opposite of ours as commissioners which could push costs up considerably.’