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CCGs want ‘influence’ over national GP contract



CCGs want to influence the direction of the national GP contract to ensure it fits with their strategic agenda, a commissioning leader has admitted.

CCGs ‘collectively’ want to have a say in what the core part of the contract looks like, chief clinical officer at NHS Blackpool CCG and co-chair of NHS Clinical Commissioners (NHS CC)Dr Amanda Doyle said at the Pulse Live conference in Manchester last week. However she moved to reassure GPs that the new co-commissioning regime, where CCGs are invited to hold part of the budgets for GP services, was not about breaking up the core GP contract into a set of different local arrangements.

She said: ‘What we have said is that collectively CCGs might like to have some influence in how that contract looks, so that it fits with the strategies that we’re all developing, but what we don’t want to do is take away negotiation of the core national contract.’

Dr Doyle later told Pulse that it would not mean being present when the GPC and NHS England negotiate the terms of the core GP contract, but that CCGs should have a say on the ‘direction of travel’.

She said: ‘People haven’t put their expressions of interest in yet so I can’t say conclusively, but certainly from the CCGs I’ve talked to there doesn’t seem to be any appetite at all for having anything other than a single, nationally negotiated contract. Although CCGs will welcome the opportunity to commission local additions to that contract, and to make some additional parts to the contract very locally specific.’

‘I think it is important that CCGs collectively are able to influence the shape of the national contract [but] I am not asking for NHS CC to have a chair around the negotiating table at all. We are definitely not asking for that. It is just that CCGs collectively may wish to have an influence over the direction of travel for the national GP contract, but we certainly don’t want to break up that contract. What we would like to do is reassure people like the GPC and the LMCs that we are not looking to disband the national contract.’

GPC deputy chair Dr Richard Vautrey said that CCGs were right to ‘steer away’ from getting involved in the core contract but warned that they should also stay away from influencing QOF and DES funding.

He said: ‘GPs and practices would be alarmed if they felt that CCGs were in some way undermining the national contract, which is the thing that provides stability to every practice in the UK, not only in England.’

‘Local areas whether they were PCTs or whatever were always able to invest in local services over and above the core contract and I think that is what they should be doing, they shouldn’t be falling into the trap of utilising the very limited resource, and dwindling resource, in the core contract for additional work. What they should be doing is identifying new resource for investment into general practice to improve the services and utilise that resource to deliver their significant agenda.’

He added: ‘What the core contract should be is the global sum or PMS baseline, the limited amount of resource that now goes into QOF, and the limited number of DESs there are now. CCGs have a responsibility to build on the core contract, not to undermine it.’

‘I think as commissioners CCGs will undoubtedly, as PCTs before them, want to influence the mandate that NHS England develops which then is brought to the negotiating table [with the GPC] in the future.’