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GP commissioners should involve out-of-area GPs in decisions to avoid conflicts of interest, says Monitor



CCGs should involve out-of-area GPs or other CCGs when deciding whether to commission services relating to GP practices to avoid conflicts of interest, according to the regulator Monitor.

Monitor has issued guidance on procurement, patient choice and competition regulations, designed to set out the criteria the regulator expects CCGs to use in making procurement decisions.

It states that commissioners should consider using competition as a way of driving up the quality and efficiency of the services supplied by GP practices and other providers.

This comes as commissioners have expressed doubts about how to comply with competition regulations that state that they must put services out to tender unless they can prove they can be provided by only one provider.

The guidance addresses the issue of conflict of interests when CCGs are deciding ‘whether to commission services that would reduce demand for services provided by GP practices under the NHS General Medical Services contract’.

In circumstances such as this, the guidance says, CCGs should involve out-of area GPs or other CCGs: ‘It may be possible for a CCG to manage a conflict affecting a substantial proportion of its members by involving third parties who are not conflicted in the decision-making by the CCG, such as out-of-area GPs, other clinicians with relevant experience, individuals from a health and wellbeing board or independent lay persons.’

Monitor´s guidance also attempts to clarify competition rules. It states: ‘Competition between providers, whether to attract patients or to obtain contracts to provide services, can incentivise providers to improve both the quality of the services they provide and value for money.’

’What will work best for any given service will depend on the circumstances. For example, providers earn income for many elective services, based on the volumes of patients they treat. A provider’s income is therefore dependent on the number of patients they are able to attract. Patients may choose to go to particular providers for a range of reasons such as reputation, clinical outcomes and waiting times.’