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Lansley rebuffs calls for commissioning groups to hold GP contracts



Health secretary Andrew Lansley has dampened speculation that the NHS Commissioning Board will devolve responsibility for GP contracts to clinical commissioning groups (CCGs).

Last month Pulse interviewed Future Forum chair Professor Steve Field and the Government’s commissioning tsar Dame Barbara Hakin who both said CCGs should be delegated responsibility for commissioning general practice in order to properly rebalance the NHS away from hospital-based care.

Though enhanced service and walk-in centre commissioning will be handed to CCGs, the NHS Commissioning Board will retain control over core GP services and other primary care areas. Speaking at a Reform conference in London this week, Mr Lansley stressed that in these areas he wanted to take a national approach to ensure ‘consistency’.

In response to a question from Pulse, Mr Lansley said: ‘The NHS Commissioning Board has a responsibility to deliver commissioning of care on primary medical services and because we are looking for consistency I think that is a plus.’

He added that this should be done in conjunction with the pharmaceutical needs assessment and the joint strategic needs assessment conducted through the Health and Wellbeing Boards. 

‘That is the essential starting point for the view that the NHS Commissioning Board needs to take about the need for additional services if there is a need for them in any particular area,’ Mr Lansley said.

The health secretary also defended the NHS Commissioning Board, describing criticism that it is a ‘centralising quango’ as ‘ironic’ considering the other clinical commissioning changes.

Mr Lansley added: ‘Albeit that we are strengthening the “N” bit in NHSCB, actually by creating statutory bodies in CCGs there is a major transformation in the shift of control in the NHS closer to patients.’

Speaking to Pulse after the event, NHS Confederation chief executive Mike Farrar said CCGs would struggle to make an impact on the local health economy without the ability to commission primary care.

He said: ‘If you divorce primary care spending from the secondary care budgets you will find a real problem about how you can decommission services in hospitals and re-provide them in the community.’

‘About a third of the people in hospitals don’t need to be there but to be able to move them out you need the primary care alternatives and it would make sense for CCGs to be able to commission those as they decommission unnecessary secondary care.’

GPC deputy chair and Leeds CCG chair Dr Richard Vautrey told Pulse he supported the health secretary’s stance.

He said: ‘Andrew Lansley is right to resist calls for the commissioning of general practice to be done by CCGs.’

‘We have a national GMS contract, with most PMS contracts mirroring this, so it makes sense for the NHS Commissioning Board to commission primary medical services. However, we do believe that CCGs should have the power to commission local enhanced services to enable, where appropriate for that local area, the resourcing of new work moving from secondary to primary care.’