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Consortium view: Dr Robert White

Dr Robert White, reducing admissions lead with Carrick Commissioning Consortium in Cornwall, on the overlap between the clinical and the manageriakl, apathy in primary care and cutting through layers of red tape.

I became commissioning lead for my surgery because nobody else wanted to do it. I also strongly believe the way to get better patient care is to have a high level of input from clinicians.

I spend a lot of hours thinking about the overlap of work that exists in the NHS, both clinical and managerial. Duplication is expensive, slows things down and confuses patients.

I am paid for being a GP and commissioning has to fit around this. Being at meetings has an impact on my practice and patients.

• Not fully engaged is the phrase that sums up our PCT's attitude to GP commissioning.

• Keen but frustrated is the phrase that sums up local GPs' attitude to GP commissioning.

• Luke warm was the initial attitude of our local acute trust – I am not sure they are fully engaged yet.

Our greatest achievement as a consortium is meeting regularly in good humour, and maintaining some enthusiasm. Successful projects include developing local ultrasound services, physiotherapy provision and work around community hospitals. A county-level acute GP service has improved patient care, reduced medical admissions and made significant savings.

My greatest achievement through commissioning is putting the team together for the acute GP service. The clinicians are outstanding, and the PCT managers involved in the set-up are unique.

The most frustrating thing about GP commissioning is layer upon layer of red tape that gets in the way of simple projects that clearly improve patient care and save money.

The biggest threat to GP commissioning success is apathy in primary care and objections to change.

I am optimistic that GP commissioning will lead to better, more efficient and streamlined patient care and better understanding between primary and secondary care , PCT and clinicians.

GP commissioning would be transformed overnight if commissioning groups were given control of real budgets on a consortium level as announced in the recent white paper.

• In five years' time GP commissioning will either be a dodo or a phoenix. We will have hopefully set up a county-wide referral management centre.

Dr Robert White, reducing admissions lead with the Carrick Commissioning Consortium in Cornwall Dr Robert White, reducing admissions lead with the Carrick Commissioning Consortium in Cornwall