By Ian Quinn
GP leaders have been handed control of the UK's biggest commissioning budget, as the first major evidence emerges of a dramatic shift in the balance of power in the NHS.
In London, the centre of controversy over top-down management of the NHS, talks between SHA managers and the RCGP, BMA leaders and PEC chairs have resulted in plans for a new strategic commissioning body, led by GPs.
NHS London, facing a £5bn debt crisis, has agreed all major policy decision in primary care commissioning must have sign-off from GP leaders, including the controversial rollout of polysystems. It has agreed to ditch targets to dump 60% of A&E and 55% of outpatient workload on GPs.
Dr Tom Coffey, a GP in Wandsworth and clinical director for NHS London, said it had acted on health secretary Andrew Lansley's intervention and planned to consult all GPs involved in commissioning over how the new strategic body will operate.
He said: ‘We have held our first meeting, which brought together the RCGP, LMC representatives and PEC chairs from across London. It won't be easy because there isn't universal consensus but most GPs realise the important thing is to work together.'
Dr Michelle Drage, chief executive of Londonwide LMCs, said negotiations had already begun about bringing major changes to a string of unpopular policies, also set to include plans for child specialists to run paediatric care out of polyclinics and to cut the length of GP consultation times.
She said: ‘The health secretary has made clear there should be a cessation of all service reconfigurations until they have the approval of GPs and in London that's happening. We're in discussions and working at full pelt to free GPs from bureaucracy. We want control of real budgets as quickly as possible.'
Dr Sam Everington, a GP in Tower Hamlets who has advised Mr Lansley on his plans, welcomed the move and said it should be a model for the rest of the country. ‘We've got to put GPs in the driving seat,' he said.Dr Tom Coffey: 'It won't be easy but most GPs realise the important thing is to work together' Dr Tom Coffey: 'It won't be easy but most GPs realise the important thing is to work together'