Exclusive LMC secretaries and chief executives who also hold a role on the boards of clinical commissioning groups are standing down from one of their roles to sidestep an ‘unavoidable’ conflict of interest as CCGs move towards authorisation.
A Pulse investigation has found a series of LMC leaders, including the GPC’s deputy chair, have resigned from CCG boards, while others have opted to stand down from their LMC to play a leading role in commissioning.
CCG board members in Leeds and Coventry have stepped down to continue with LMC roles, while Dr David Hughes stood down as North Staffordshire LMC chair in April 2011 to become chair of North Staffordshire CCG.
Dr Richard Vautrey, deputy chair of the GPC, stood down as chair of Calibre, one of three developing CCGs in Leeds, in September in order to continue as assistant medical secretary at Leeds LMC.
He said: ‘As we moved towards authorisation processes I felt that was the right time for me to withdraw from the CCG role.’
‘The GPC has always made it clear that as CCGs move towards having statutory responsibilities, at some point individuals need to decide whether they are going to be LMC officers or CCG officers before the conflict of interest starts to be too great for them to be both.’
Dr Jamie Macpherson, secretary of Coventry LMC, stood down from Coventry’s Godiva Clinical Commissioning group last month.
‘There were already conflict of interest pressures coming in and I think it is going to get greater,’ he said.
‘I can see in the future times when LMCs will be at loggerheads with CCGs, because I think LMCs look after GPs from a provider perspective and that may, at times, be a different agenda to commissioners.’
The moves highlight the growing conflict of interest dilemmas hitting GPs as CCGs move towards authorisation. In June, Pulse revealed that one GP in 10 on the boards of new commissioning consortia also held an executive-level position with a private provider.
Dr Andy Mimnagh, chair of Sefton LMC, said it was becoming impossible to hold both positions.
‘I am co-opted in advisory role to the CCG but wouldn’t become a board member, as I think there would be a fundamental conflict of interest,’ he said.
‘The problem arises when you realise that the CCG is eventually going to have approval, and the authority of the NHS in each area, and at the same time they will negotiate contractual matters with the LMC. You can’t sit on both sides of the table.’
What the BMA says
BMA guidance states that it is ‘advantageous’ for LMC leaders to be involved in the early stages of CCG development but said ‘it would be improper for a GP to hold a substantial role within their LMC and be a clinical leader in the consortium once the transition stage was completed or after April 2013 and the formal transfer of commissioning responsibility to consortia.’
However a presentation given by GPC negotiators this month appeared to up the ante, stating: ‘LMC officers now need to consider conflicts of interest if also a CCG officer.’