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NHS Confederation: White paper reforms lack mechanisms to hold GPs to account



By Gareth Iacobucci

The Government’s NHS reforms lack effective mechanisms to hold GPs accountable for their commissioning decisions, the NHS Confederation has warned.

In its response to white paper, the confederation said that GP consortia as described ‘do not appear to be clearly accountable to patients and the public’, and called for urgent clarification.

The confederation pinpointed the daunting financial challenge as ‘the area of greatest risk’ to the plans, saying: ‘It will be exceptionally difficult to deliver major structural change and make £20bn of efficiency savings at the same time.’

It added there was ‘potential for failures in the quality of patient care and financial control.’

Concerns were also raised about GPs’ capacity and capability to take over commissioning, amid fears that skills and experience from PCTs ‘are likely to be lost’.

The confederation also warned against an ‘over-reliance of market mechanisms’ to manage the new system, cautioned that some of the incentives in the proposed system could act against integration and called for GP consortia to have more influence over health inequalities.

It added the scale of the cultural change needed ‘has been underplayed’, adding: ‘More needs to be done to explain the shift away from top-down management and to help the public, the NHS, media, and MPs to understand its implications.’

David Stout, director of the NHS Confederation’s PCT Network, said: ‘Our members fully support the principles set out by the Government to empower patients and clinicians. However, we have concerns about the risks these changes could have on the quality of patient care and financial control without a clear implementation plan.’

‘There are also many areas laid out in the white paper which require further clarity with regards to accountability.’

David Stout: ‘We have concerns about the risks these changes could have’ David Stout: ‘We have concerns about the risks these changes could have’