NHS Alliance chief Dr Michael Dixon has called on the Government to ‘put its full weight' behind GP commissioning to prevent the policy being a failure.
In his new year address to GPs, Dr Dixon questioned the coalition's support to health secretary Andrew Lansley in speaking up for the reforms, and said the pause in the reforms was viewed as ‘a tacit message that Government was not fully behind them'.
Dr Dixon said commissioning risked becoming a ‘Marie Celeste' if its leaders deserted while the policy was pushed through in a way that was far more bureacractic and restrictive than initially outlined.
He said the NHS Alliance had ‘complete confidence in clinical commissioning leaders all over the country', but warned their enthusiasm was at risk of dissipating.
His main concerns include the role of the National Commissioning Board, the level of support for CCGs from the coalition Government, and whether clinical commissioning groups (CCGs) will be able to develop a strong and unified voice that is heard and understood.
Dr Dixon said he was also anxious about being able to ‘re-create a belief in clinical commissioning, when it comes to frontline clinicians' in response to ‘the mixed messages of the past many months'.
He said: ‘There is spreading disillusionment and distrust amongst these leaders and many are privately considering leaving these roles. Worse than having no expectations is when expectations are dashed.'
‘The new CCGs are under threat of becoming centrally driven, overly "bureaucratic" and emasculated organisations. This would be the opposite of all that had been trailed by the secretary of state and NHS senior leadership.'
'It would also be the opposite of what is needed to deliver much better services and much needed economies. We must learn from the past and not become, once again, victims of it.'
Dr Dixon's five solutions for successful clinical commissioning are:
1. The coalition Government, as a whole, needs to put its full weight behind CCGs and CCG leaders.
2. The National Commissioning Board must show (not simply say) that it really does ‘get' clinical commissioning.
3. We must create an independent representative organisation that will bring together CCGs and their leaders and become a force to be reckoned with.
4. Frontline clinicians must become the answer not the problem with GPs and other clinicians beginning to see clinical commissioning as a blessing rather than inevitability.
5. CCGs and their leaders must command the confidence and input of their frontline clinicians and patients. Working with Health and Wellbeing Boards they need to become effective new champions for localism and clinical commissioning with a primary care focus.