By Ian Quinn
All GP practices will be made to join federations or consortia by the autumn of 2012 - and from April 2013 these will be funded directly by the new independent Commissioning Board .
The board will have the power to force GP practices to be assigned to a federation if they do not do it themselves, and the federations will be expected to police the standard of commissioning by practices.
Under plans revealed in the White Paper, GPs will not be permitted to directly commission services provided by other GPs, but will have increased influence, with commissioning carried out by the NHS Commissioning Board instead.
However, funding from the board will be paid direct to GP consortia rather than individual practices, with consortia expected to 'hold practices to account' for their commissioning performance.
The Government expects to open negotiations with the GPC shortly over the new GP contract, which will include individual responsibilty for commissioning.
This looks set to be a key battleground, with the recent LMCs conference overwhelmingly passing a motion opposing any move to make commissioning complusory.
But Government insiders have insisted that they do not want to repeat the mistake of GP fundholding, which they claim failed because it was not compulsory.
The White Paper says: ‘A fundamental principle of the new arrangement is that every GP practice will be part of a consortium.'
‘It is envisaged that the NHS Commissioning Board will establish a comprehensive system of GP consortia and we envisage a reserve power for it to assign practices to consortia if necessary.'
‘There will be a need for negotiation and a need for contractual changes with GPs,' said Mr Lansley, who added that he had met with the GPC twice before the election to discuss his plans and representatives from the Government had met with BMA leaders as well as other groups since to discuss how the new commissioning plans would work, ahead of a full consultation due to start soon.
He added: ‘I'm clear from my discussions with GPs around the country that many GPs are ready to go, raring to go. They just don't have the legal and financial framework to make it happen.'
‘In places where GPs are reluctant and hesitant we will support them through the independent health board.'All GPs will be expected to be working within a federation by 2012 All GPs will be expected to be working within a federation by 2012 Your questions on the White Paper
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