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GPs force ministers into U-turn over ‘any qualified provider’

Exclusive GPs have helped force the Government into a U-turn on the use of any qualified provider, with commissioners now entitled to decide if and when they open up services to competition.

Pulse first revealed back in October that the Department of Health was reviewing its policy of opening up community and mental health services under AQP after primary care groups including the NAPC and NHS Alliance raised concerns that it was being ‘foisted’ upon GPs.

The row came after PCT clusters were controversially asked to select three services to open up under AQP this year, leading to concerns that commissioners were being forced to use competition even where not appropriate under ‘bonkers’ DH rules.

Health secretary Andrew Lansley signalled the shift in a letter to CCGs earlier this week, which said commissioners would not be forced to subject services to competition, with the final choice always resting with commissioners.

In an exclusive interview with Pulse, Dr Charles Alessi, NAPC chair and a member of the Clinical Commissioning Coalition run jointly with the NHS Alliance, said GP leaders had managed to talk the Government into a rethink on the policy, to enable CCGs to decide whether to use AQP to stimulate competition.

Dr Alessi said: ‘Through a lot of discussion with the Department of Health and the coalition, together with the RCGP and Family Doctor Association, we have reached a position where perhaps people feel comfortable. We have a process which we can use in a way which is sensitive, doesn’t fragment the market and gives clinical commissioners the ability to make the changes they need for their population.’

‘It is the commissioner that makes all the decisions on whether they should use AQP, whether they should use tendering or whether they should not use competition at all. Post 2013, the decision will be the CCGs’ and the CCGs’ alone. There will not be the diktat, they will make that decision based on their population and their health needs assessment.’

‘Theoretically one could see complete fragmentation happening [under the old plans]. Now we have a process which makes it clear that that doesn’t need to happen, and actually, that won’t happen.’

A Department of Health spokesperson said: “We have consistently said that competition should always be in the interests of patients, not an end in itself. It has always been our position that clinical commissioners should decide these things, because they are best placed to understand both their patients’ needs and where competition can be used to improve services.

‘It will be for CCGs to decide in which services they want to introduce a choice of any qualified provider, reflecting local needs, the quality of existing services and patients’ views. The onus will be on commissioners to act transparently and to justify their decisions in terms of benefits to patients.’