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GP leaders attack plans to increase competition in community services

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Leading GPs have attacked the Government's plans to increase competition among community services using ‘any qualified provider' from next April.

From April to September, patients will start to be offered a choice from a list of qualified providers for certain community services when they are referred by GPs, which the Government hopes will drive up competition in the health service. But GP leaders have criticised the drive as ‘ideologically driven' and contradictory.

Under guidance published last month by the Department of Health, PCT clusters and GP commissioners have to choose three community or mental health services from a list provided by the Department of Health to implement AQP.

The list includes adult psychological therapies, diagnostics in the community, musculoskeletal services and podiatry services. PCT clusters and GP consortia have to choose the three community or mental health services they intend to use by this September, and implement AQP in April to September 2011.

BMA Council member Helena McKeown said: ‘Clinical commissioning groups (CCGs) will have a duty to promote joined up services both within the NHS and between health, social care and other local services.How can CCGs do this whilst introducing three choices of community services provider?  Here is the first example of a post amendments oxymoron.'

Dr McKeown also warned that the AQP would mean that personal health budgets will be extended across health and social care, because they are the simplest way for patients to pay for one of the choices created.'

‘This would be another very bad development as personal health budget bring many inherent threats including rationing and the widening of health inequalities,' Dr McKeown said.

GPC deputy-chair Richard Vautrey told Pulse: ‘The AQP document is clearly more about ideology than improving patient services.'

‘At a time when PCTs have had to cut back on commissioned psychological services in order to cut costs, it is hard to understand how a PCT cluster is now expected to find the money to commission more services again and at the same time control demand.'

‘The same situation applies to musculoskeletal services. Lots of patients who currently see physios or chiropractics privately will simply ask to see them on the NHS instead, making it harder for commissioners to control demand and costs will rise as a result.  The Government's ideological plans don't join up with the financial reality.'


List of suggested areas for AQP

• Musculo-skeletal services for back and neck pain

• Adult hearing services in the community

• Continence services (adults and children)

• Diagnostic tests closer to home such as some types of imaging, cardiac and respiratory investigations to support primary assessment of presenting symptoms

• Wheelchair services (children)

• Podiatry services

• Venous leg ulcer and wound healing

• Primary Care Psychological Therapies (adults)

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