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BMA warns local area teams will struggle to cope

The BMA has ‘serious concerns’ about workforce issues in local area teams that could affect the way in which practices are performance managed, it said in its submission to a parliamentary enquiry on the healthcare reforms.

It said that the reduced number of staff in the local area teams compared with their PCT predecessors will risk the development of strong relationships between practices, LMCs and the commissioning bodies, which hold GPs’ contracts.

The submission to the House of Commons Health Committee official inquiry into the Health and Social Care Act rollout also raised issues around CCG constitutions, section 75 competition regulations and the speed with which the act has been implemented.

The BMA wrote: ‘We have serious concerns that the reduced workforce in the new structures will make it very difficult to carry out the funcions transferred from PCTs. For example, effective performance management of GP practices requires close communication between the commissioner (previously the PCT, now area teams), the LMC and GP practices. A reduced workforce in area teams, which cover wider geographical areas than PCTs, may risk making the development of these strong local relationships more difficult to establish and maintain.’

It was also concerned that some CCG constitutions still have inappropriate clauses handing them power to place contractual sanctions on practices, as well as a lack of clarity on appointments, appeals procedures and conflicts of interest.

It said: ‘It is important that NHS England takes a proactive approach to ensuring that CCG constitutions are fit for purpose.’

The BMA further called for ‘absolute clarity’ over when commissioners can sidestep competition law requirement to tender for all contracts.

It said: ‘The BMA believes that absolute clarity is needed on how competition will be managed in the NHS now that the Health and Social Care Act has come into force. There continues to be considerable confusion over when commissioners will have to tender all services in the absence of expected guidance from Monitor and further Government assurances.’

The health committee’s review is in its final stages and is expected to report final conclusions during the third quarter of the year.