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Federations likely to ‘provide not commission services’, says RCGP chair

By Richard Hoey

GP commissioning consortiums and federations will not be necessarily the same thing, and the proposals in the recent health White Paper will result in GPs often becoming members of both, RCGP chair Professor Steve Field believes.

His comments come as a surprise as it was widely assumed that the White Paper’s plans for commissioning consortiums would directly build upon the college’s federation drive, which has begun to pick up pace over recent months.

Earlier this year, the RCGP called for all GPs to sign up to federations as a matter of urgency to avoid collaborative structures such as polysystems being imposed upon them.

But Professor Field said that need could remain even if GPs were also signed up with a consortium, because federations would largely concentrate on provision of services rather than commissioning, as one way of avoiding potential conflicts of interest.

He urged GPs to enter talks with neighbouring practices as soon as possible to decide how they wanted commissioning and provision to work.

‘Commissioning is one thing and provision is another. You could have a federation providing services within or indeed across commissioning boundaries,’ he said.

Professor Field told Pulse he expected GP consortiums would be substantially bigger than federations especially in urban areas, with a single consortium taking over commissioning for large parts of his home city of Birmingham.

‘We might have a single consortium covering the whole of south Birmingham or even the whole of the city, and it might be that federations could be set up just to provide, with competition between federations.’

The White Paper on health did not specify how large GP consortiums should be, other than to say they should be large enough to be able to manage financial risk.

In more rural areas, Professor Field said consortiums and federations might have the same member practices, but that it was also possible the boundaries of the two might not match up.

He stressed GP consortiums would be strictly geographical groupings, and suggested federations might not be, with it more important that they were ‘like-minded’.

‘I don’t see why practices shouldn’t work together at a national level to provide services. It’s possible – this should be led by GPs.’

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