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Pioneering GP consortia assume early responsibility for commissioning

By Ian Quinn

Exclusive: GP consortia are set to take over responsibility for commissioning decisions ahead of schedule in more than half of PCTs, in a boost to health secretary Andrew Lansley's claim that GP have embraced his plans.

Of 32 PCTs providing details to Pulse of their schedule for handing over commissioning responsibilities, 18 said they were are on course to have shadow GP consortia up and running before the target date of April next year.

The survey suggests GP commissioning leaders are largely ignoring the BMA's warning against moving too fast to form consortia, and comes as the NHS Alliance by contrast called in its official response to the white paper for the Government to allow GPs to take over now.

The Government, which has been criticised by many for the pace of its change, had expected shadow groups to get up and running during 2011/12 , ready for GPs to take charge of budgets the following year and full budgetary responsibility from April 2013, when PCTs are scrapped.

But some trusts are already beginning to sign practices to formal consortia agreements and hand over responsibility for budgets. GPs have signed a deal with NHS Cambridgeshire that will see two consortia take control of the bulk of local commissioning, with Hunts Health and Borderline Commissioning Consortia taking over in Huntingdonshire, and Yaxley and Whittlesey, respectively.

Dr Paul Zollinger-Read, a GP and chief executive of NHS Cambridgeshire, said: ‘This launch marks the culmination of many month's work with our GP colleagues. We've used this time to design a robust system that will enable GPs to buy services directly for their patients.'

Dr Simon Brown, GP Lead of Hunts Health, said: ‘This is a wonderful opportunity. There is no doubt it will be challenging - but we're confident we have the infrastructure in place.'

Elsewhere, NHS Hertfordshire has just agreed for a new GP consortium to take over control of acute hospital budgets, while NHS East Riding said it had provided £1m for consortia to take over ‘smaller projects and pilots'.

NHS Nottingham City said: ‘It is hoped consortia will be established, at least in interim or shadow form, early next year. This will have a significant impact on every GP practice.'

In its white-paper consultation response, the NHS Alliance called for a dual-track introduction of commissioning, to allow trailblazing GPs to take on budgets as soon as possible, but give less accomplished commissioners more time to prepare.

Dr Pauline Brimblecombe, a GP in Cambridge, said the four shadow clusters across the country were already piloting real budgets, and could eventually form the basis of the new consortia.

‘Things are happening quite quickly. GPs now realise that they are the arbiters of spend. It's that acceptance of responsibility that takes such a long time to accept. Once GPs are on board, they realise there are better ways of doing things.'

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The trailblazers: PCTs expecting to beat April 2011 deadline

NHS Portsmouth
NHS Hounslow
NHS East Riding
NHS Bristol
NHS Cambridgeshire
NHS Ealing
NHS North Lincs
NHS Dorset
NHS Dudley
NHS Birmingham East and North
NHS north East Lincs
NHS Nottingham City
NHS Richmond
NHS Herts
NHS Calderdale
NHS Cumbria
NHS Haringey
NHS Mancs

Dr Pauline Brimblecombe