Managers are rejecting GP ideas and putting strict conditions on how a new £100m fund is spent, even thought the additional cash was meant to ‘harness the expertise of local clinicians’.
The fund, totalling £100m, was trumpeted by ministers as a landmark in the devolution of NHS power to clinical commissioners, but GPs on the ground say their plans for spending the money have been hijacked by PCT managers.
Earlier this month the DH announced it would allocate clinical commissioning groups (CCGs) funding equating to £2 per patient to ease the winter pressures on the NHS and to allow ‘prospective CCGs to implement measures which support their longer term plans.’
At the time, Health Secretary Andrew Lansley declaring that GP commissioners ‘know better than anyone, what their patients need’, but commissioners in some parts of the country say their ideas are being ignored.
In Greater Manchester at least one CCG has seen all of its plans for spending the DH fund rejected by NHS managers, despite proposing interventions similar to ones recommended by the DH, including improving arrangements with nursing homes to reduce emergency admissions.
In Merseyside, GPs say they have been frustrated by the PCT cluster’s decision to plough part of the funding into a pre-agreed plan for extended opening for GPs.
A letter from Dr Stephen Cox, Medical Director of NHS Merseyside cluster, says that the cluster will give GP practices 50p per patient for the scheme. The letter states that the ‘best use of this funding will be at the discretion of the CCG’ but lists a series of ‘conditions’ including that the ‘additional capacity must be available after 4pm’ and ‘must be audited during March 2012 to demonstrate the impact on urgent care.
A GP involved in commissioning in this area, who asked not to be named, told Pulse: ‘We were just told here is the 50p per patient -setup surgeries after four o clock. The medical director at the Cluster had the main input. It was a fait accompli by the time it came down to us.’
‘It is incredibly frustrating and it almost feels like a conspiracy to hinder our progress of CCGs.’
A spokesperson from NHS Merseyside defended their plans, saying: ‘The remaining £1.50 is intended for primary care investment, the details of which are being discussed with Merseyside CCGs.’
A spokesperson from NHS Greater Manchester, said: ‘The vast majority of proposals have been accepted. These focus on reducing overall winter pressures particularly in A&E.’
Dr Shane Gordon, chief executive of North East Essex CCG, said that PCT’s dictating the way funding should be spent ‘was not in the spirit’ of the DH’s plans.
Dr John Hughes, secretary of Manchester LMC, said he was concerned at the pressure being put on CCGs to submit plans quickly.
He said: ‘The CCG I’m involved in is just finalising our plans. My concern is that there’s not enough time to do this. If this money was available for winter pressures, we should have been told about it in September or October to be able to plan properly.’
‘It is the same thing as usual. It’s no way to run a service’.
A Department of Health spokesperson said: ‘We would expect emerging CCGs, harnessing the expertise of local clinicians, to identify how best to use this funding to improve patient services, and to work with their local PCT cluster on their plans. PCT clusters needs to approve these plans and ensure the money is spent on frontline patient care.’