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Commissioning dilemma: Lack of resource to support time spent on commissioning

The amount of time your nominated clinician is spending on commissioning duties is way above the time he’s reimbursed for via the management allowance. Do you accept this is an inevitable consequence of commissioning, go to the group requesting extra funds or insist that he keeps his work within the hours for which he’s reimbursed? Dr Simon Poole advises

If GPs are to embrace the challenges of Commissioning in the long term it is vital that this is adequately resourced. Success is likely to be dependent on all practitioners having the capacity to invest time and enthusiasm to create the best for patients in a challenging financial environment. Consortia will need to understand that their most valuable asset is the engagement and commitment of GPs and that this will only flourish where it is appropriately supported.

Clinicians involved in consortia have a special responsibility to lead colleagues, and to show through example that excellence in commissioning begins with best practice in individual patient care at practice level within the constraints of available resource.

If time spent by a clinician on commissioning duties was placing additional burdens on the practice then this would need to be addressed, either through increased financial support or through management changes in the consortium.

Spending more time on commissioning duties than the consortium resources must not be an inevitable consequence of the commissioning agenda. Individuals and practices have a responsibility to value their time appropriately and if neccessary seek additional funds from the Consortium management allowance to support this work. Practices and partnerships must feel that individual clinicians are funded adequately and that the functioning of clinical services is not diminshed by underfunding or poor recognition of commissioning work.

Commissioning work may however attract enthusiasts who choose to spend time on initiatives outside working hours. This is of course no different to many facets of our professional working lives where we are individually responsible for making choices which may impact our working and domestic commitments. We must as ever rely on the support and feedback of our partners, colleagues and appraisers, respecting our different values and ambitions.

Dr Simon Poole is vice chair of the GPC’s commissioning and service development sub-committee, and a GP in Histon, Cambs

Dr Simon Poole