Exclusive: Evidence is emerging that CCGs are struggling to involve GPs in their configuration and decision-making, with initial results of practice surveys showing that many GPs feel frozen out by the new organisations.
An analysis of reports from the NHS Commissioning Board’s CCG authorisation 360° stakeholder surveys for the first wave of new organisations shows many practices reporting a lack of involvement and understanding of their CCGs’ plans.
The NHS Commissioning Board said the results of the surveys would be used to help assess CCGs for authorisation, but said it was not a prerequisite that all practices were ‘actively involved’.
In Islington CCG, North London, 56% of GPs responding to the questionnaires, carried out by IPSOS Mori, said they either ‘did not feel very involved or not at all involved’ in decisions about the proposed ‘configuration, structure and governance arrangements’ of their CCG,
Similarly, 50% of practices in Oldham CCG, 43% in Dudley CCG, and 41% in East Leicestershire and Rutland CCG said they did not feel involved in decisions being taken.
In both North East Lincolnshire CCG and Liverpool CCG, a third of GP practices said they did feel involved, while three in five practices in Liverpool also said they were not clear about the arrangements in place for the delegation of functions within their CCG.
Only 39% of practices in Portsmouth CCG, and 52% in Islington CCG said they understood the financial implications of their CCG’s plans.
Also in Islington CCG, only 40 % of GPs said they understood what was required of their practice to implement plans, while only 32% were satisfied with the timeliness of the information they were receiving.
West Cheshire CCG had more positive feedback, with 79% of practices saying they felt involved in discussions, which the report said was ‘significantly higher than the average’.
Dr Russell Walshaw, chief executive of Humberside Group of LMCs, which includes North East Lincolnshire LMC, said communication issues and GP apathy were present across his patches.
‘I know North East Lincolnshire CCG has had a review of the processes, and one of the recommendations was about how they are communicating with their practices.’
He added: ‘In a lot of the meetings, people don’t turn up which may reflect GP apathy because an awful lot of GPs just want to get on with their practice work and seeing their patients.’
Dr Rob Barnett, secretary of Liverpool LMC, told Pulse: ‘People are quite rightly sceptical that CCGs are just new PCTs. As GPs we all have a day job to do and that is more important than attending CCG meetings.’
The NHS Commissioning Board has said the formal assessment of CCGs will be based on evidence gained from a combination of the 360 degree surveys, desk-top reviews, case studies and site visits.
Its guidance on authorisation says: ‘We don’t expect every GP in every practice to be actively involved in the work of the CCG. However, we do expect effective engagement mechanisms to allow participation and sign up to the constitution.’
A spokeswoman for the NHS Commissioning Board said: ‘There has been a high level of responses to the stakeholder surveys so far, and we are confident generally that there has been a good level of engagement by CCGs with general practices.
‘Where there are any concerns about the levels of engagement demonstrated in a stakeholder survey, these will be picked up by the panel assessors during the site visit.’
Although some CCGs have chosen to publish their surveys, the NHS Commissioning Board said it would not be publishing them centrally.
The spokeswoman added: ‘Results of the 360° stakeholder surveys are interim, operational reports designed to help each clinical commissioning group in its journey towards authorisation.
‘The surveys were carried out on a strictly confidential basis to ensure open and honest responses from the participating stakeholders: the CCGs themselves have no way of knowing which of their stakeholders took part. As such, the NHS Commissioning Board has no plans to release 360° survey reports.’