Exclusive GP commissioning leaders are quitting the boards of clinical commissioning groups amid concerns that even enthusiasts for the NHS reforms are being ground down by excessive workload and frustration at bureaucracy.
A Pulse investigation covering 50 PCTs found 15 CCG board members have stepped down since April. Among those who resigned from board roles were CCG chairs and commissioning enthusiasts who found it impossible to juggle commissioning with their clinical work.
Board members have stepped down in Fareham and Gosport, Southampton, Wiltshire, Coventry and Warwickshire and Dorset.
Dr Patrick Craig-McFeely, a GP in Salisbury, resigned as chair of Sarum NHS Alliance commissioning group and stepped down from the CCG board last month. Dr Craig-McFeely, who was previously heavily involved in practice-based commissioning, said the experience had had a major impact on his professional and personal life.
‘It was taking over my family life and hitting the care I felt I could provide to my patients. It seemed to be getting ever worse,' Dr Craig-McFeely said.
‘When commissioning was announced it sounded like GPs would be able to do what they thought was right. But it has shifted to us being accountable here and accountable there and a whole lot of management speak. You never seem to be making any progress.'
The time pressures on CCG chairs have also led to one of the country's most prominent advocates of GP commissioning standing down. Dr Johnny Marshall, chair of the National Association of Primary Care, quit as chair of the United Commissioning LLP, soon to become a CCG in Buckinghamshire, after he found it impossible to devote enough time to the role alongside his other commitments.
Dr Marshall, whose term as NAPC chair ends in January, said he will stay on the CCG board and remains committed. But a snapshot survey of 16 GP commissioners exposed further disillusionment and frustration.
One GP who asked not to be named warned of central pressures and said their CCG had been ‘told there is no point in trying to temper decisions of the SHA and Department of Health'. And Dr Gurmit Mahay, chair of Wolverhampton Primary Care CCG, said: ‘My diary has become blocked with CCG-related meetings, putting a strain on my other commitments. I have spoken to other CCG leads and they are all in a similar boat, with some ready to throw in the towel due to excessive pressure. Some are calling it "death by committee".'
The warnings come as Paul Corrigan, a former Labour health adviser, claimed diktats from PCTs and SHAs were leading to mounting disengagement: ‘What I have been hearing are stories of GPs told to come to meetings at eight hours' notice, rewrite submissions over a weekend and generally being kicked all round the room.'
Despite the difficulties, a number of CCG leaders remained positive. One said: ‘All change processes cause difficulties – it's a bumpy road ahead but one we will certainly travel.'
Dr Michelle Drage, chief executive of Londonwide LMCs and generally an enthusiast for commissioning, said GP engagement had reached a critical juncture as morale started to slide: ‘We're at the cusp – there's a lot of scepticism and de-motivation. We are beginning to see, even where people were very engaged, the PEC and PBC effect coming through.'
In GPs' words
‘The CCG role was becoming too much. I had to make a choice and in the end my priority was my patients.' Dr Patrick Craig-McFeely
‘The system as it is set up is heavy on meetings, which we as doctors are having to do on top of busy clinical schedules.' Dr Gurmit Mahay
‘I'm stepping down from the chair role as it really needs more time that I can commit.' Dr Johnny Marshall