The GPC's lead negotiator on commissioning Dr Chaand Nagpaul has said commissioning will only succeed if it has buy-in from all grassroots GPs.
Speaking at last week's NHS Confederation conference, Dr Nagpaul said: 'We need to recognise that this agenda, the ability for clinical commissioning to succeed, particularly for groups to achieve the savage financial efficiency savings that we're being asked to make, can only work if it has the engagement, buy-in and corporate loyalty of all GPs. And in particular grassroot GPs, in terms of the clinical decisions they make in the consulting room, their choices on whether to refer or not to refer, whether to investigate, whether to prescribe a drug. This is what will affect the financial performance of a commissioning group and therefore our focus needs to be on the grassroots GPs.'
Summing up the many debates at the recent BMA and LMCs annual conferences, he said there was GP support for clinical commissioning but that this came with 'caveats and safeguards'.
GP commissioners wanted support to commission 'that has not necessarily been their experience in the past', and have concerns that need to be addressed about the role of the clinical commissioning boards and what clinical senates would entail.
'This new dimension of what a clinical senate is - I'm not quite sure what this means,' he said.
Dr Nagpaul added that GPs also wanted to maintain the trust and support of their patients.
At the same conference session, Dame Barbara Hakin said it was important to remember clinical commissioning groups would still be 'the statutory bodies responsible for delivering the best care they can and will be allocated the funding'.
She added GPs would still be the 'central tenet'.
Dr Nagpaul also acknowledged the BMA faced ' a real challenge' in trying to represent all GPs.
'I am in the enviable position of representing the total spectrum of GPs' views. Not just the minority who will be leading this reform agenda but in fact the much larger majority who are either apathetic and many who are both sceptical and cynical.'