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Commissioning overhaul confusing to GP practices

A quarter of GPs and practice managers in one area were unaware their CCG had taken on co-commissioning of general practice since April, a survey at one LMC has revealed.

The survey by Cambridgeshire LMC received over 200 responses, 70% of which were from GPs, and found that overall 25% did not know the local CCG had taken on a co-commissioning role in a joint committee with NHS England.

Even those GPs and practice managers who were aware the CCG was now involved in co-commissioning did not necessarily understand the implications – nearly 40% said they did not understand what this meant.

Cambridgeshire LMC undertook the survey in July in order to gauge local GPs’ and practice managers’ views on whether Cambridgeshire and Peterborough CCG should take on fully delegated co-commissioning – due to be considered by the CCG at its September meeting.

However, one in ten respondents said they did not even know how GPs are currently being paid, with NHS England holding the contract for core, QOF and directed enhanced services work and the CCG and local authority holding others.

A third were not aware of the plan for fully delegated co-commissioning, and less than half had read the CCGs’ documents on the proposals.

Nonetheless, the LMC said that overall GPs’ answers demonstrated ‘an impressive understanding of the issues involved’, and that concerns over the available budget were more pressing than those over potential conflicts of interest.

It concluded that ‘very few people had a certain answer’ and that the final decision would depend on what the CCG’s due diligence report revealed.

Co-commissioning is the term chosen by NHS England to describe CCGs taking joint responsibility for commissioning general practice services alongside area teams, which for example allows them to invent new local incentives to replace things like QOF and national enhanced services.

CCGs with full delegated commissioning responsiblity handle the majority of GP contracting on behalf of NHS England, with 65 CCG already taking this on from April this year and more expected to follow. GP leaders’ main concern around the move has been around conflicts of interest.