By Ian Quinn
NHS managers are warning that the transfer of power from PCTs to GPs is resulting in chaos on the ground, with a lack of detail in the white paper leaving GPs unaccountable and unmotivated.
In its response to the white paper, the NHS Confederation's Primary Care Trust Network has urged the Government to rush out emergency transition plans, including a confirmation that GP consortia will inherit responsibility for PCT debts and contracts.
It claims GPs are not engaging in efforts to slash PCT spending because their future responsibilities have not been clearly set out. It also calls for the Government to release a list of services that PCTs could immediately stop, as many battle to prevent huge deficits spiralling out of control.
‘There is an urgent need for a clear implementation plan to be put in place,' PCT Network director David Stout says in the report. 'It's important to clarify that GP consortia will inherit both contractual commitments from - and the financial position of - PCTs. To do otherwise would disincentivise GPs from engaging in current decision-making at a time it is critical they become more involved.'
Meanwhile NHS London chief executive Ruth Carnall has warned that massive management cutbacks combined with the SHA's financial crisis has put the capital's ability to cope with winter pressures under threat.
She said by 2013 London's smallest PCT would have just 65 staff, adding: ‘It is very unlikely that such a PCT could maintain firm control of finance and performance as it prepares to hand over its legacy to local consortia of GPs.'
Chris Locke, chief executive of Nottinghamshire LMC, echoed her concerns.
‘There is already a growing fear among GP leaders that PCTs may soon be incapable of carrying out all of their responsibilities adequately, while still helping consortia get established,' he said.
‘Across the country, thousands of PCT staff have cleared their desks, leaving bewildered and demoralised colleagues with the task of restructuring what remains in order to fulfil the PCTs duties.'David Stout: Need for a clear implementation plan David Stout: Need for a clear implementation plan