This site is intended for health professionals only

GPs take control of acute services in new commissioning model

By Nigel Praities

Exclusive: GPs will seize control of all the elective activity and operations at their local acute trust in a radical new commissioning model being considered by NHS managers, Pulse can reveal

The plans – drawn up by practice based commissioning groups in Surrey – aim to contribute to £150 million in savings for their local PCT and will make them one of the first to road-test plans from the Conservatives to write responsibility for local commissioning into the GP contract.

Local GPs say the proposal could see all outpatient activity; A&E and operations for the Epsom and St Helier NHS trust being managed by a local independent sector hospital.

Andrew Lansley, the likely new health secretary, visited one of neighbouring Guilford clusters last month and said GPs in the area were ‘ready and able' to take on the additional responsibility of commissioning care.

‘We will rely on them to do so to improve care for everyone in Guildford,' he added.

But the plans have been criticised as wholesale privatisation of services, with a real risk the savings the NHS Surrey want cannot be delivered.

Dr Oliver Bernath, managing director of Integrated Health Partners - the company working with Mid-Surrey Commissioning Group on the plans - said the details were currently being worked out and would depend on the results of the election.

‘It would cover all planned care and unplanned care, and the only thing that would be separate would be the hospital's prescribing,' he said.

But Dr Peter Stott, a GP in Tadworth, Surrey, and chair of the MEDLInC PBC group, said the scheme was financially motivated and had not been thought through properly.

‘They are taking us down the road of really privatising healthcare in this area and it is based on the PCT wanting to make savings of £150 million this year.

‘It is all very well to say you can do it for less, and the PCT will say "Thank you very much." But actually to deliver on that is another matter.

‘Practices may or may not understand what they are getting into. From our perspective, we would prefer things to proceed more carefully than they are being,' he said.

A spokesperson from NHS Surrey confirmed they were considering a proposal to ‘strengthen joint working' across primary and acute care in the Guildford and Waverley area.

‘Nothing has been decided and there's still much work to do before there are any firm options,' she said.

Andrew Lansley: keen for GPs to take on responsibility for commissioning care and to hold budgets Andrew Lansley: keen for GPs to take on responsibility for commissioning care and to hold budgets