This site is intended for health professionals only

Commissioning dilemma – being signed up to a pathfinder without your knowledge

Your practice and all those around you have been signed up as part of a pathfinder without your knowledge. You're convinced there has not been proper consultation about its structure and which practices should be included? Dr Brian Balmer advises GPs on what action to take.

'How did I become part of a Pathfinder?'

This situationmay sound peculiar, even comical, but it has actually occurred and in doing so has caused great confusion to practices. Some people are also naturally irritated by what they perceive to be high handedness on the part of their "commissioning leads".

There are a few simple actions to take in this situation in order to review the consultation process which should have taken place. Ask surrounding practices what they know about the Pathfinder and if they were consulted. The next obvious places to check are the LMC and the PCT, and the leadership of the consortium itself. If you don't know how to contact your consortium leads then you automatically have a problem. The consortia system, if it ever gets off the ground, will only be successful if it involves practices in ways that PCTs could not establish. The SHA is also a useful source of information as they will have approved the application, although they can appear rather remote and are not generally practice friendly.

The questions to ask are:-

• Are we in a Pathfinder?

• When did we apply?

• Was this communicated to practices?

• Does the Consortium constitution allow this to happen without a practice signature?

• Is there a Consortium constitution?

• What is the structure and size of this GP commissioning consortium?

• What are the next planned initiatives?

• How do we become more involved?

Virtually all practices will be in Pathfinders by the Summer, and so there will be no-one left on the ground to benefit from the information on where this is going. Does it therefore matter if you are in a Pathfinder without having had the opportunity to support or question it? Yes it does. You might be planning to leave the consortium and join another; you might want to reform your consortium; you might simply believe you should have a say.

This is not a game and practices should be treated with courtesy and respect. A lack of consultation is to be deplored.

On the other hand, your questions of others in your practice and colleagues in other parts of the district may reveal a more disturbing truth. Are you the only one who didn't know? Why did they tell everyone but you? Is it paranoia or Alzheimer's you should worry about? A combination of the two is the worst scenario. You might have forgotten how worried you should be.

Dr Brian Balmer chief executive of Essex LMCs and a member of the GPC's commissioning and service development sub-committee

Dr Brian Balmer