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GP Commissioning: dispatches from the frontline

Dr James Kingsland introduces the second element of his new column, where he will provide commissioning dispatches from his own practice in Wallasey, Merseyside. To begin with, he sets out why his practice chose to join a small CCG.

Our practice decided at an early stage to begin its journey in clinical commissioning in a small CCG.  Having been at the vanguard of most health service reform for primary care over the last 20 years, the decision was taken in the light of that experience and in the knowledge that really affecting reform of primary care both as provider and commissioner would be best achieved through an affinity and inclusive approach with colleagues who had similar goals to ourselves.

Our CCG approach is to ensure that every clinician and manager in every member practice is well informed, takes on some leadership responsibility (true distributed leadership) and works as a collective.  We recognise that for some larger scale strategic changes, procurement of new local providers and contract management we will be working in association with other CCGs at scale for this work.  However to bring critical peer review and change behaviour in day to day practice which aggregated across practices brings real change at scale, we feel our approach is right for our practice. 

We recognise that we need to break the mould of the old system and ensure that our ‘local’ NHS is shaped collectively by the people that have responsibility for delivering this service.

Whatever the outcome of CCG development, we must create a bright future with a new paradigm – not create the style of organisations that we are currently dismantling. 

As Albert Einstein stated ‘any fool can make things bigger and more complex.  It takes a touch of genius – and a lot of courage to move in the opposite direction’.