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CCGs may take five years to be successful, say commissioning leaders

CCGs may take up to five years to successfully engage GPs and bring about meaningful changes to their local health service, one of the country’s most senior GP commissioning leaders has warned.

Speaking at the Conservative party conference in Birmingham last week, Dr Johnny Marshall, interim partnership development director of NHS Clinical Commissioners (NHSCC), insisted that CCGs’ engagement with practices was ‘improving’ but acknowledged that in some areas it was ‘not good’.

He said that the NHS Commissioning Board should only partly authorise groups which were unable to demonstrate engagement, with the removal of conditions dependent on better local partnerships with GPs and other healthcare professionals.

Pulse recently revealed that some CCGs have struggled to engage member practices, with initial results from practice surveys showing many GPs feel frozen out of the decision-making by the new boards.

Dr Marshall, a former chair of the NAPC and GP in Wendover, Buckinghamshire, said: ‘Clinical leadership will successfully shape general practice. How long is that going to take? In some places it is happening already because they have been doing practice based commissioning for five or six years. If you are looking at the next five years, it is going to take that length of time for the majority of people to develop the necessary relationships and partnerships.’

‘You can’t just come in and stop people from referring, or challenge people. For many of us who have been involved in practice based commissioning it has taken that long to really get that bedded as the new culture of the organisation.’

Dr Marshall said the process would be slower for some as CCGs were ‘starting from a different position’ of little or no clinical engagement.

He said: ‘The reality is you can’t put a timetable and say you must all have a relationship by 1 April 2013. That is an unrealistic vision.’

‘The NHS Commissioning Board recognises that in some areas relationships are developing really well and in other areas they are not. It should be recognised if they do not have these relationships and form part of their conditions [of authorisation].

Dr Michael Dixon, interim president of NHSCC, chair of the NHS Alliance, and a GP in Cullompton, Devon, agreed: ‘It will take three to four years until we see total visible change in the organisational system. It takes time to turn a tanker around.’

‘I think there will be some low hanging fruit with some new commissioners that will be hitting the ground running while for others it will take longer.’

Click here to read the editorial: Building a new NHS will take time