The vast majority of Clinical Commissioning Groups are not satisfied with the commissioning support being offered to them, with leading GPs warning that a failure to address the concerns will see the quality of NHS care ‘regress’.
A survey of 95 CCGs across England conducted by the National Association of Primary Care and NHS Alliance found that 70% of CCGs are dissatisfied with the commissioning support on offer. The survey also found that 84% of CCGs felt they had not been given enough information about commissioning support options, as commissioning leaders warned some GP commissioners are being strangled by centralised control.
The poll also reveals a split in the reasons CCGs have opted to take on PCT commissioning support services. One in five GP commissioners opted to use their local PCT cluster’s offering ‘because they were too busy’ to pursue alternatives, but a quarter said they had commissioned support from NHS managers ‘because relationships with PCT support staff were good.’
GP commissioning leaders said that the survey findings raised concerns over the degree to which CCGs are being hampered by central control and being treated as ‘servants of their commissioning support’. They said CCGs should be able to ‘determine with whom they work and at what price’.
Dr Charles Alessi, chair of the NAPC and a GP in Kingston, Surrey, said: ‘[What] we are seeing here is central control, which is incompatible with the intentions of the Bill. Clinicians must be given the scope to determine with whom they work and at what price. The propositions, being put forward in some Strategic Health Authority clusters, will severely restrict CCGs ability to transform and modernise care.’
‘Unless our concerns are addressed, the NHS will no longer be able to offer care to all free at the point of delivery across the range of services currently available and this country will regress in terms of the quality of care it offers.’
Dr Michael Dixon, chair of the NHS Alliance and a GP in Cullompton, Devon added: ‘We must get this right as soon as possible. Clinical Commissioners should be treated as intelligent customers not, as happens in some areas, as servants of their commissioning support.’
The GPC has repeatedly voiced concerns that the NHS reforms will see commissioning support outsourced to major private sector providers. In a letter sent to the profession last week, GPC chair Laurence Buckman restated fears that the outsourcing of commissioning support will see private providers become ‘the defacto CCG management’ and said the GPC instead advocated that CCGs should come together to form their own commissioning support services.
Dr Buckman’s letter stated:‘We believe this [outsourcing of commissioning support to the market] will lead to the privatisation of commissioning, destroy the public health dimension to commissioning, with a loss of local accountability to local populations, and is likely to exacerbate health inequalities. There is no good reason why CCGs, or groupings of them, could not run their own commissioning support service, within the NHS, and this is something we advocate.’