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GPs set for greater powers to combat acute trust overspends

By Gareth Iacobucci

Exclusive: The Department of Health is poised to add more levers into acute trust contracts to give GPs greater negotiating powers with hospitals, says a senior Department of Health official.

Richard Dodds, the Department of Health's NHS Contracts Lead, said he wanted GPs to be more actively involved in writing contracts, and in developing local indicators to allow them to scrutinise acute activity more closely.

It comes as information obtained by Pulse under the Freedom of Information Act revealed the extent of acute overspending that GP commissioners will have to tackle in some parts of the country in order to manage budgets and deliver savings for the Government's Quality Innovation Productivity and Prevention (QIPP) agenda.

Speaking at the National Association of Primary Care's London meeting, Mr Dodds said the Government was keen not to avoid a 'commissioner-beating-up-the-provider' contract, but wanted GPs to be able to develop local flexibilities that would allow them to get a grip on wild acute spending.

The need for more leverage is underlined by the figures obtained from Pulse from a series of overspending PCTs.

NHS West Sussex reported a £14.7m acute deficit in 2010/11, while NHS Salford posted a £3m overspend across all provider contracts.

In Warrington, meanwhile, the PCT said it had challenged coding issues with Warrington and Halton Hospitals NHS Foundation Trust to the value of £215,000 last year.

Mr Dodds said the focus of the contract should be on increasing acute participation in national clinical audits, and called for monthly clinical quality reporting, introduced on an optional basis for hospitals this year, to be adopted more widely.

He said: 'I want the contract to be simpler, and easier to use. The commissioners I spoke to were amazed at what was in the contract. I want clinicians to be involved in writing the contract.'

NAPC London chair Dr Charles Alessi, last week unveiled as a member of the Government's future forum panel to take forward the NHS reforms, said the Department of Health was offering GPs a great opportunity to influence acute behaviour.

He said: 'It's up to us to step up to the mark, to make the contract a little more real to pathfinders. We need to publicise the fact that there is a conduit.

'The only way we can have influence as commissioners is to influence the contract. We have to team up with colleagues to manage the big beast that is acute trusts.'

GPs set for greater power to combat acute trust overspends