GP commissioners are being ´set up to fail´ in their task of commissioning £60 billion worth of NHS care because they have no training or infrastructure to fall back on, experts have warned.
A leading healthcare academic says GPs are the latest group to become commissioners without any training, following on from PCT managers, many of whom ´did not choose to be a commissioner at all, but gained the title in a previous reorganisation.´
Writing recently in The Guardian, Professor Jon Glasby, director of the Health Services Management Centre at the University of Birmingham said: ´While commissioning is a powerful tool, confidence seems to be being placed in it without the necessary infrastructure in place to support commissioners to deliver.
´They worry that too much is being expected of them in a difficult policy context without the necessary focus to turn commissioning into a career of choice for future public service leaders.
´Commissioners are asking: where are the commissioning-focused MBAs? Why is there no Royal College for Health and Social Care Commissioners? Where are the introductory textbooks and training programmes to help people develop new skills?
´Add to that a range of policies that seem to give greater powers to providers – such as foundation status for acute hospitals – or the ongoing tendency to reorganise commissioning bodies on a regular basis, and commissioners are often left weaker than providers.
Responding to the article, Doug Forbes, chair of the Institute of Healthcare Management´s commissioning division said: ´In commissioning, our leaders were set up to fail over five years ago when commissioning came into vogue and focus, yet were not afforded the opportunity to develop the skills and expertise required to carry out this key, complex activity.
´In short there has been a lack of clarity in defining and understanding commissioning by many who saw it as solely a procurement function.´
Dr Amit Bhargava, co-lead of the NHS. Alliance's GP Commissioning Federation said it could be useful for GPs to have a commissioning qualification but GPs could bring a lot of their existing skills to the job
´A lot of GPs have done jobs with the PCT as PEC chairs and so on so they are not completely naive to commissioning. Ou advantage is we´re local and understand the population and can triangulate the patient experience with the money etc.
Ít´s always good to improve the science of commissioning and there will be new skills to learn. But I´m an optimist that feels we can do this well if we have the right support. We´ll all use the system at some point so we´re doing it for ourselves too.´