Rock-bottom management allowances could force cash-strapped GP commissioning groups to share back office support functions with local councils, it has emerged.
Clinical commissioning groups currently using DH toolkits to work out soft budgets for commissioning support are finding they will not have enough to afford their own back-office functions and could have to pool resources with neighbouring CCGs or other bodies.
Dr Bill Cotter, commissioning lead of Bexley CCG told Practical Commissioning that his calculations - based on a management allowance of £25 a head - suggested it would be impossible for his group to function independently.
He said they were urgently exploring collaborations on support functions such as human resources with neighbouring CCGs and with the local council.
He said: ‘Once we become approved, it looks as if things are going to be even more tight than they are now.'
‘Even with 230,000 patients, we just won´t have enough to manage. All options have now got to be explored including working with the local council.'
'We could look at sharing back office functions with them, especially for areas we are commissioning jointly. It makes sense.'
‘The potential problem is that the council could end up having more influence than we´d have liked. We would want assurances in that respect.'
'For an all-singing all-dancing CCG, you´d probably need a population of about a million to make it economic,' he added.
Dr Cotter's comments came in the wake of a Practical Commissioning analysis of the viability of smaller CCGs.
Dr Mark Spencer, chair of Fleetwood Community Commissioning Group in north Lancashire, which has only three practices and 25,000 patients, said groups like his would be forced to share back-office functions with others.
He said: ‘We´re looking at getting together with Blackpool CCG for support which would take us up to about 180,000 population which might just be doable. If we collaborate with Fylde coast that would take us up to more than 300,000 but we may not need to.'
Dr Cotter said he believed that it was important for all smaller CCGs to explore collaboration options: ‘I do wonder how one can not take this on board because the figures just aren´t adding up.'