NHS managers are ‘bullying' clinical commissioning groups by imposing authorisation deadlines against GPs' will, muscling in on CCG recruitment processes and dictating Any Qualified Provider (AQP) terms, the GPC has warned.
A number of GPC representatives reported concerns to yesterday's GPC council meeting that PCTs and central Government are pressurising CCGs.
GPC negotiators said commissioners are being leant on to set dates for authorisation, while regional GPC representatives attacked PCTs and SHAs for muscling in on CCG recruitment processes and riding roughshod over GP objections to the way AQP is being implemented.
GP leaders said the attempts to dictate authorisation dates to CCGs flew in the face of Department of Health commitments. Following the Government's health bill ‘listening exercise', ministers pledged that CCGs would only take on full commissioning responsibilities when they were ‘ready and willing', rather than the original 2013 deadline.
‘CCGs are being bullied into developing in ways their members are not happy with,' said Dr Laurence Buckman, GPC chair and a GP in Barnet. ‘[CCGs] can do whatever they want to a timetable of their choosing. The government has made it clear that there will not be a 2013 deadline in quite the way that was envisaged.'
Dr Buckman's warning came as GPC members in the North West and Essex raised concerns at the pressure being put on CCGs.
Dr John Hughes, GPC representative for Salford and Trafford, Manchester and Stockport, said GP commissioners had been told that PCT executives should sit on selection panels for recruiting lay board members to the CCG.
‘The cluster sent an email that said it was acceptable for CCGs to appoint former PCT non-execs to the board but where CCGs are holding open applications [for lay members] then the chair of the PCT had to be involved and sit on the panel. They don't have any remit to do that at all.'
An NHS Greater Manchester spokesperson confirmed that the chair of the PCT cluster will be involved in the appointment of lay members. ‘The chair will provide a view but the ultimate decision still lies with individual CCGs. We believe the majority of our CCGs will welcome this support,' the spokesperson added.
Dr Brian Balmer, a GPC member and chair of Essex LMCs, said PCTs were refusing to ‘let go' of commissioning, and were sending a ‘very strong signal' that they wanted to approve the appointments of CCG boards.
‘In parts of Essex we're getting a very, very strong signal that the PCT want to approve the chair of the CCG. I think that is the way the old world works – that is the PBC model, it is not clinical commissioning. At some point the PCTs have got to let go.'
‘The CCG idea is that once the board is elected, the board should then choose their chairman – that is the way most organisations function. People who are credible and well qualified on the [CCG] board should choose who their chair is. But the PCT wants a PCT process.'
Dr David Wrigley, GPC representative for Cumbria and Lancashire, said PCTs in his area had imposed AQP terms on GPs despite CCG opposition. Dr Wrigley said one CCG had declined to select three areas to put out to AQP on the basis they were satisfied with current provision, but claims the local PCT then imposed three areas on the CCG.
Dr Wrigley said: ‘I presume the PCT received direction from up high. It's trickling down from the DH, to the cluster to the CCGs. It smacks of more of the same of the top down, Whitehall management. We said no but it was still imposed on us. This is a taste of what's to come really.'
