BMA calls for major rethink over GP consortia

By Ian Quinn

The BMA has called for the proposed GP commissioning consortia to be radically re-modelled to include a much broader range of clinicians.

Secondary care consultants and other clinicians must be given decision-making powers alongside GPs, it says, in its official response to the white paper consultation.

The association warns the proposals in their current form will not work because there is a lack of incentives to encourage greater co-operation between primary care and hospitals, as well as other services.

‘It is absolutely essential that all these expert clinicians play a central role in commissioning decisions and, as such, whilst GP-led, consortia must design local mechanisms that ensure consultants and other specialists are brought into the decision making process,' it says.

It accuses the white paper of being too focused on ramping up competition, rather than driving more integrated care for patients.

‘It is clear that real and meaningful clinical engagement in commissioning is crucial. However, there appear to be few incentives in the white paper to encourage such cooperation: indeed the emphasis and continuing and even widening the purchaser-provider split seems to actively discourage this.'

The BMA warns that unless consortia are designed to include all types of clinicians in a clinical pathway, GPs may find themselves baring the brunt of patient anger over unpopular commissioning decisions.

‘It is possible some patients may view GP-led commissioning with suspicion. As such, it will be essential to develop and implement a system that maintains trusts and protect professional values. The system should be as transparent as possible and assure patients that their doctor is referring them to a particular provider purely because it will provide the best clinical outcome.'

Dr Richard Vautrey, GPC deputy chair, said the lack of plans for more integrated care in the white paper was ‘one of our fundamental concerns', although he admitted there would need to be a ‘common sense approach' to insure against potential conflict of interest in commissioning decisions.