Large CCGs should divide into local clusters of practices to ensure that they engage GPs in their commissioning decisions, concludes a new study.
The study found that large CCGs may have increased negotiating power and less risk of financial failure – but they will struggle to engage local GPs in commissioning processes because of their size.
Researchers made this conclusion after examining the challenges facing GP leaders at six CCGs and local clusters in the east of England, covering 208 GPs.
The researchers analysed how CCGs were functioning by observing board and executive meetings, surveying 58 CCG board members and conducting interviews with GPs, practice managers and PCT staff.
The research team was led by Professor Eivor Oborn, a professor of health care management at Warwick University. She said: ‘As network size increases it becomes more difficult to for leaders to engage with frontline members.
‘Thus leaders kept stressing that if they ignore the size issue they will fail to get GPs engaged and on board.’
Some sites tackled the problem by developing smaller ‘localities’; clusters of practices within their network which resolve local issues including commissioning, said Professor Oborn.
One GP interviewed for the study commented: ‘Frontline engagements won’t work at the 300,000 patients level…therefore having those sub-groups, those cluster level groups, is vitally important.’
Dr Michael Dixon, a GP in Collumpton, Devon, interim president of NHS Clinical Commissioners said: ‘This is a well put warning by the researchers. If there is a division between CCGs and local practices then we will be lost.
‘Here in Devon we have the largest CCG in the country but we have divided it into sub-localities, so GPs are not expecting to have relationships only with the main CCG body itself.’
The study was published this month by BMJ Open.