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Half of GPs have changed their clinical practice since becoming CCG members

More than half of GPs have said that being a member of a CCG had altered their referral or prescribing patterns, a study by the King’s Fund and the Nuffield Trust has revealed.

The survey found that almost 60% of the 207 respondents in six chosen CCGs had altered prescribing patterns, almost 75% had changed their referral pathways and just over 50% had changed their referral volumes. One in five grassroots GPs forecast this would have a negative effect.

The study also revealed a ‘considerable’ disconnect between CCG leaders and grassroots GPs. Of the 74 CCG leaders asked the question, 66% felt that their CCG was ‘owned’ by its members compared with 35% of the 232 GPs without a formal role in the CCG.

Furthermore, 81% of leaders believed that decisions made by the CCG reflected their views and those of their co-workers, compared with 38% of those without a formal role in the CCG.

The study authors wrote: ‘The most commonly cited effect of CCGs was that peer-to-peer dialogue had heightened GPs’ awareness of their referral and prescribing patterns and how they compare with those of others. In most sites, at least some practices or localities reported that this had led to their succeeding in reducing their referral rates or prescribing costs.’

However, they warned: ‘We also found a considerable difference of perspective between GPs involved in leading CCGs and those who had not taken an active role.’

The study said: ‘If the gap between active participants and other local GPs grows wider over time, there is a clear risk of CCGs losing their connection with grassroots GPs and repeating the history of diminishing clinical involvement that characterised many primary care trusts’

Holly Holder, fellow in Health Policy at the Nuffield Trust said: ‘CCGs will have to sustain the support of their membership and demonstrate how participation from local GPs adds real value to their work. CCG leaders should know which areas of clinical practice GPs perceive to be legitimate spaces for CCGs to influence, and which strategies could risk disengagement.’