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‘PCTs seem to be imploding’: LMC reaction to the Government’s GP commissioning plans

Read what LMC secretaries across England are saying about the commissioning proposals – and what they’re hearing from their grassroots members.

Mike Forster, secretary of Gloucestershire LMC

‘We are playing it cool. We feel it’s too premature to get involved. We won’t do anything until the GPC gives us more detail. There won’t be very many GPs ready to take on the role, apart from those already involved in PBC. There will be a need to buy in expertise, maybe existing PCT staff. With hope, rather than expectation, we hope to have meetingsin October or November. We don’t want to go in the wrong direction.’

Chris Locke, secretary of Nottinghamshire LMC

‘Meetings are being organised with cluster leads. It’s interesting that GPC are saying don’t rush in but the reaction locally has been that we need to get our head around this as soon as possible. There’s already a vacuum developing. PCTs seem to be imploding. People are disappearing over the horizon, including chief executives. The feeling is that some PCT staff are trying to steer consortia in a particular direction.’

‘Where we come to the point where we decide on consortia, we are suggesting that maybe we can help with vetting commissioning support they will be getting in the future, whether from existing PCT people or the private sector. We can help mange the beauty parade before you decide who you want to work with. Don’t be brow-beaten into maintaining the status quo.’

‘The concern is that we may be throwing the baby out with the bathwater. There are so many PCT functions that don’t have a home, the Government hasn’t thought about where they will end up.’

Dr John Grenville, secretary of Derbyshire LMC

‘We’ve had an open meeting which was well attended. In Derby City, we’ve set up an action group to look at possibilities and report back. These are being attended by medical director, chairs of PBC groups, GPs and practice managers. At county level, representatives of all 14 PBC groups are meeting, and we’ve looked at where we might go from here. The main problem is we have no idea what consortia will do. I think those who had an interest in PBC anyway are looking and thinking about it. But most people haven’t really appreciated the full extent of what’s going to be asked of them. I don’t think you can say ‘yes’ or ‘no’ at the moment.’

Dr Jane Lothian, secretary of Northumberland LMC

‘In terms of the concept, we are extremely positive about it. It’s what we’ve been asking for for years. Everybody is pretty enthusiastic.’

‘But the thing we are very concerned about is that the destruction of SHAs and PCOs is rather unnecessary. As much as we love to spar with them, everybody has worked very hard to get the system working, and the whole system is just about maturing. There is a lot of disagreement, particularly among our practice managers. We are sorry for our colleagues in the PCO. We are very concerned that organisational memory will go. Consortia will have to undertake statutory obligations with half the management cost. The enthusiasm is tempered by real concern.’

Dr Richard Brown, medical director at Surrey and Sussex LMCs

‘GPs are taking it very seriously. A number of formal and informal meetings have been held. One issue is will the resources be there? GPs don’t want to take the blame for a system that isn’t resourced properly. There is a lot of interest. We are replying to the consultation but it’s a difficult to know what questions to ask. We are a bit in limbo at the moment.’

A Kent LMC spokeswoman

‘We’ve had a number of meetings with our localities. As always, some will be leaders, some are anxious. The fact that all the lines are not down is a security for some, insecurity for others. We are doing our own submission [to the Government’s consultation].’

Dr Rob Barnett, GPC member and secretary of Liverpool LMC

‘We had an LMC meeting this week of 140 GPs. People are positive but apprehensive at the same time.’

‘It’s very clear we haven’t got some of the answers. Main concerns are from those who have not been so active in PBC and those who want to get involved more. Also discussion about how to harness the enthusiasm of younger GPs, debts, and where will responsibility lie.’

Dr John Grenville: ‘Most people haven’t really appreciated the full extent of what’s going to be asked of them’ Dr John Grenville: ‘Most people haven’t really appreciated the full extent of what’s going to be asked of them’