Plans to tie up a portion of CCGs administrative costs in a quality premium dependent on their performance will hinder their ability to commission effectively, the GPC has warned.
The Government announced yesterday in its draft ‘NHS mandate' for the NHS Commissioning Board that the financial premium, which CCGs will distribute to GP practices based on commissioning performance ,will be drawn from overall NHS administration costs, and not CCGs' management allowance.
The GPC has been staunchly opposed to the introduction of the premium, claiming it could increase health inequalities by starving some CCGs of valuable funding, and damage the doctor-patient relationship if patients perceive GPs could gain financially from commissioning decisions.
GPC deputy chair Dr Richard Vautrey said the latest detail provided in the mandate had not changed the GPC's view.
Dr Vautrey said: ‘On the quality premium, we stand by our wider concerns about health inequalities and potential threat to the doctor-patient relationship.'
‘CCGs really should have had this money from the beginning. They will need every penny. If any resource is held back, that will hinder their ability.'
‘There is no new money,' he added.‘It's effectively money that previously would have been used to fund PCTs. One of the things that's yet to be answered is what proportion of CCGs income will be wrapped up in this. We hope it's as little as possible.'
Dr Vautrey said the mandate itself was general enough to give CCGs the freedom to set their own priorities, but said he remained concerned about CCGs being ‘sandwiched between the NHS Commissioning Board and Commissioning Support Services'.
Other reactions to the NHS mandate
‘This mandate broadly ticks the main box - it keeps things relatively simple and consistent. Unlike documents that have gone before it, the mandate does not seek to develop an ever growing "wish list" of objectives. It rightly encourages commissioners to exercise their knowledge of the needs of their local communities to plan and deliver the best care.'
Mike Farrar, chief executive of NHS Confederation
‘We welcome the inclusion of quality aspirations in the mandate in line with the five domains of the NHS Outcomes Framework, in particular ensuring that people have a positive experience of care. We wish to see quality improvement aspirations reflected in both the NHS Commissioning Board's response to the mandate and all clinical commissioning groups' commissioning plans.'
Sir Richard Thompson, president of the Royal College of Physicians
‘We are very pleased to see that mental health has been made a priority in the draft mandate and we welcome the objective to ensure mental health is put on a par with physical health. Many people with mental health problems tell us how important dignity and respect are to their care and support - it is heartening to see strong references to these values throughout the mandate.'
Paul Farmer, chief executive of Mind
‘The NHS needs simplicity and clarity. What it has got is a dense document with 60 outcome indicators grouped within five domains. He is loading a whole new set of targets on an NHS that is already struggling with the challenges it is facing.'
Andy Burnham, shadow health secretary
