Exclusive NHS England is proposing to cut the number of area teams by merging them into ‘much bigger’ structures, prompting fears the move could cause ‘inevitable chaos’ for GP practices, Pulse can reveal.
The mergers could see a reduction in the 25 area teams – currently in charge of GP commissioning – as part of possible changes to the structure of NHS England which are currently under discussion by senior managers, Pulse understands.
GP leaders expressed concerns that the move could lead to a further loss in experience across NHS England employees, resulting in more confusion for GPs about who they should be contacting and creating bigger distances between practices and their commissioners.
Area teams have struggled to pay practices in the past because of chaos behind the scenes at NHS England, Pulse has reported, with some GPs left confused by the way payments and reimbursements were being allocated following the abolition of PCTs last year.
A GP leader, who has been briefed recently on plans by an NHS England official, told Pulse: ‘There is a review of the area team footprint going on. There was a correspondence that came out on Monday to very senior managers within the area teams, and we understand that there is going to be some mergers of area teams which we have all been expecting. I suspect that you will see a reduction of area teams of between 25-50%.’
GPC negotiator Dr Beth McCarron-Nash confirmed that she had also heard the same details. ‘That is right, the area teams are getting much bigger,’ she said.
Some GPs also raised concerns that bigger area teams may lead to bigger CCGs in future, as area teams struggled to manage many small structures.
Dr John Canning, secretary of Cleveland LMC said he expected area teams will become ‘much, much, much bigger’, ‘perhaps to the level of previous regions, which were 14 traditionally but came to seven at one stage in the past’.
He said: ‘It will create greater distances from the activity. [I wonder] will they be able to manage more CCGs or will it lead to wanted and perhaps unwanted CCG mergers.’
GP leaders, including the BMA, raised concerns last year that the reduced number of staff in the local area teams compared with their PCT predecessors would risk the development of strong relationships between practices, LMCs and the commissioning bodies, which hold GPs’ contracts.
And Birmingham LMC executive secretary Dr Robert Morley said this week that the latest move could lead to further loss of ‘corporate memory’ since the PCT days.
He said: ‘The biggest issue is the inevitable chaos it will cause for practices not knowing who to deal with, new people in jobs, loss of corporate memory etc. It’s just more of the same and things get worse each time. The changes also cycle round ever more quickly and this one will be compounded by the privatisation of primary care support functions, the move to co-commissioning and possible CCG mergers too.’
Dr Tracey Vell, honorary secretary of Manchester LMC, said: ‘As we see it the staff were already thin on the ground at senior level and this may become thinner as the senior staff are merging.’
Kent LMC chair Dr Julian Spinks said: ‘My LMC has built a very good working relationship with our area team so it would be sad if we had to start all over again with yet another new structure.’
A letter sent to all NHS England staff from chief executive Simon Stevens last week (Friday 5 September) said the review of area teams ‘to be frank, is principally driven by the running cost cuts we are facing’.
An NHS England spokesperson told Pulse: ‘Discussions around possible future organisational changes across NHS England are ongoing. It would be inappropriate to comment further at this stage.’
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