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A nagging problem

How can GPs cover their clinical duties and take on the challenge of commissioning, asks Dr Paul Zollinger-Read

This week I’ve been out and about visiting consortia. Still high levels of enthusiasm and lots of good work being done, but it’s important to stress this is not a race. There’s no prize for getting to the wrong destination first and everything to be gained for getting it right…

However, let’s move to a real problem that I’d like your help in sorting out.

One thing that has been nagging away at the back of my mind and raised by quite a few of our consortia, is the question: How do we cover GP leaders who will reduce their clinical time to take on leadership roles?

Agreed, this won’t be huge numbers of GPs, but in any consortia there is going to be a need to reduce clinical time for leaders and also those GPs in each practice who will need protected time to work with their practice.

One of the lessons I’ve learnt is you need clarity in these arrangements, primarily for patient continuity and also to ensure that the day-to-day practice work is done. You don’t want to be continually having to catch up on QOF because the data wasn’t entered.

I’d be interested to hear what solutions are being developed. Some groups have been talking to local deaneries and we have seen the start of some innovative GP training developments, including commissioning skills. Others are talking to providers such as out-of-hours providers with the view that they will maintain a pool of high quality doctors who can do both OOH work and also consistently work in a practice covering, so continuity is achieved.

This is a real issue and one all consortia can not afford to sweep under the carpet. I’d be interested in what others are thinking because, think about it you must. And I suspect that this is one of many areas where consortia will need to work together. History has shown us how crucial the need is to anticipate and act on workforce changes.

Dr Paul Zollinger-Read is a GP and director of GP commissioning at NHS East of England.

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