The Commissioning Coalition of the NHS Alliance and NAPC has secured a pledge from the government that clinical commissioning groups can choose how they commission services free from top-down interference.
The Department of Health has conceded that CCGs need to be able to choose when to use Any Qualified Provider rather than having it imposed on them as in the recent order to PCT clusters to select three services to open up under AQP this year.
The Department of Health announced it would review the policy in October and Health Secretary Andrew Lansley told CCGs earlier this week that commissioners would not be forced to subject services to competition, with the final choice always resting with commissioners.
Dr Mike Dixon, chair of the NHS Alliance said the U-turn was ‘highly significant’ and should soothe public fears about competition being stimulated artificially within the NHS.
‘It´s the outcome of what we´ve been able to persuade the government behind the scenes. What we really have agreed is that CCGs should be sovereign and not wrong-footed by the NHS Commissioning Board and Monitor into taking on commissioning methods they don´t want to use.
‘It is a significant recognition of the commissioning role. It was a mistake to introduce AQP on that basis. Far too top down. This is consistent with what we´re being told privately, that CCGs will in future have a strong hand. It should go a long way towards reassuring people who are worried about competition and privatisation of the NHS.’
Dr Charles Alessi, NAPC chair said: ‘Through a lot of discussion with the Department of Health and the coalition, together with the RCGP and Family Doctor Association, we have reached a position where perhaps people feel comfortable. We have a process which we can use in a way which is sensitive, doesn’t fragment the market and gives clinical commissioners the ability to make the changes they need for their population.’
A Department of Health spokesperson said: ‘We have consistently said that competition should always be in the interests of patients, not an end in itself. It has always been our position that clinical commissioners should decide these things, because they are best placed to understand both their patients’ needs and where competition can be used to improve services.
‘It will be for CCGs to decide in which services they want to introduce a choice of any qualified provider, reflecting local needs, the quality of existing services and patients’ views. The onus will be on commissioners to act transparently and to justify their decisions in terms of benefits to patients.’