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Consortia given power over GP pay and contracts

By Ian Quinn

The Government is to hand GP consortia sweeping new powers to police and dictate funding at constituent practices, including delegated responsibility for overseeing GPs’ contracts.

Under new plans published by the Department of Health, which have been backed by the RCGP, the NHS Alliance, the NAPC and the Family Doctor Association, consortia will be expected to run regular reviews of the quality of services offered by every practice in their organisation

Consortia will use local league tables to monitor practice performance in areas such as referrals and take on whole chunks of contract management, including clinical governance and clinical audit to ensure ‘continuous improvement’. They will have a duty to ‘identify poor performance’ and call in the NHS Commissioning Board, the GMC or the Care Quality Commission to investigate or order remedial action.

Consortia boards will also be put in charge of tens of millions of pounds of enhanced services funding for practices, as for the first time some GPs take control over their colleagues’ income.

GPC negotiator Beth McCarron-Nash said: ‘This is the first time someone else will have control over your pay. It will be other GPs but I don’t think that will make it easier. In some ways it may make it harder.’

GPC deputy chair Dr Richard Vautrey said negotiators had pushed the Government to give consortia powers over enhanced services.

‘The trouble in the past has been that despite the plans for services coming out of hospital there has been no extra funding for the services in primary care. This gives consortia the power to direct that money,’ he said.

But he admitted the move could effectively force consortia to divert the funding to private providers.

‘The Government’s has any willing provider as a key part of its policy and this could lead to private firms being awarded enhanced services because they are offering the cheapest price. What you could end up with is a very fragmented service.’

Dr Kambiz Boomla, chair of City and Hackney LMC, said: ‘The problem with devolving performance management to consortia is that when patients demonstrate against the cuts, they are going to be demonstrating outside GP practices. It takes responsibility away from the Government who were happy to take the credit in the period of growth.’

Dr Kambiz Boomla Consortias’ new sweeping powers

* power to offer enhanced services funding to GPs or other providers

* delegated responsibility for parts of practice contract management, including clinical government and audit

* duty to draw up league table of local practices performance on ‘financial and quality outcomes’

* power to call in the NHS Commissioning Board, the CQC and the GMC to investigate practices identified as underperforming

Source: The functions of GP commissioning consortia: DH