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Patients covered by multiple GP consortia as pathfinders overlap

By Gareth Iacobucci

Almost a quarter of a million patients in one region of the country alone are currently covered by more than one GP pathfinder consortium, it has emerged.

The strategic health authority NHS South West, where 97% of GP practices - the highest proportion in the country - are signed up as pathfinders, said it had allowed different groups to cover the same geographical area in order to test out the most suitable structures for consortia.

But the development raises fresh questions over the future of the 141 pathfinders announced so far, with the size and structure of many still apparently in a state of flux.

The Government's draft legislation, published last week, stipulated that GP consortia must not coincide or overlap when they are established formally by April 2013.

The health bill also stated that consortia will eventually have to be formed of two or more GP providers, meaning the four single-practice pathfinders announced so far will have to merge with others.

NHS South West said the overlap between consortia, which is occurring in Somerset and Gloucestershire, was not creating a duplication in commissioning activity, as PCTs are still in charge of commissioning budgets.

The SHA said the overlap was giving fledgling consortia the opportunity to ‘test how different organisational models will work' before finalising plans.

‘Just over 200,000 people in the south west are covered by more than one pathfinder consortium,' a spokesperson said.

‘This allows the consortia to look at a variety of ways of commissioning services for patients, so that a decision on the best way forward can be made before consortia are made legal entities.'

Dr Harry Yoxall, medical secretary of Somerset LMC, said: ‘We would hope to try and work out this tension between having a large organisation with economies of scale, which runs the risk of being remote from its members and therefore unlikely to influence their behaviour, and having small organisations which are intimate, and able to affect what their members do, but which would duplicate, or triplicate, the need for bureaucratic support.'

Dr Yoxall said one of the overlapping pathfinders based in East Mendip was also considering cross-border working, as its main acute provider was in another PCT and pathfinder area in Bath.

He said: ‘Do they stay with the countywide organisation where some of their established primary care relationships are, or do they go with their secondary care provider? There's a real interesting question there.'

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