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Field : Pause has slowed progress

The head of the Government's listening exercise, Professor Steve Field, has spoken of his fears that the pause will slow progress for some commissioning GPs, when there is a need to ‘speed up some things' in places.

Speaking at a launch last night of a NHS Alliance report into how GP commissioning can make the NHS better, Professor Field said: ‘My real worry is the pause in some areas has allowed people to slow down and stop progress. And what we mustn't do is let the entrepreneurs go back and be fed up and not do their entrepreneurial work. We need to actually encourage them to speed up some things while recognising that not everybody is in the right place to take it forward as quickly as others and that's a job for the commissioning board to really support.'

Professor Field, former RCGP chair, added that commissioning groups and a focus on the needs of the population ‘have to be the way forward'.

He said: ‘For me, the more I've heard, the more I've read it's about how you manage the population.

‘How you stratify the risk of the population to try and prevent people getting into hospital in the first place.'

He also said the leadership to do this might not necessarily come from GPs.

‘How can we get the appropriate leaders? It might be a GP or might be a very charismatic nurse, physiotherapist, manager or pharmacist.

‘ I think you do need the GPs there with their energy knowledge and skills to get the clinicians there and focus on the population.'

The NHS Alliance report ‘Making it better' profiles six in-depth case studies where GP consortia with tenure have managed to deliver better care.

Speaking at the same event, Professor Chris Ham, chief executive of the King's Fund, warned against introducing bureaucracy that would put GPs off commissioning..

‘I think most of the GPs who are providing leadership in consortia are doing so because of the opportunity to improve service provision. And there's a really tricky issue here of GPs as commissioners and commissioning consortia being able to take those ‘make or buy' decisions.

‘I have had some interesting discussions with colleagues in the DH who take the view that commissioning consortia are just commissioners and they're not commissioners and providers.

‘But if we put too many hurdles in the way of consortia and GPs leading consortia using their freedoms and flexibilities to improve service provision and who do so without going through very complex and bureaucratic procurement and tendering processes then sadly I think some of the best GPs already actively involved in commissioning will decide this games isn't worth the candle and may well walk away.'

NHS Alliance chair, Dr Mike Dixon warned GP commissioning must not be seen as a means of fuelling incomes.

Creating social enterprises for GP provider companies, was a way round this he said as the profits went back into services.'

Professor Steve Field