The GPC has urged CCGs not to ‘flog off’ local enhanced services to the private sector, amid fears of a push from Government for more than £1 billion of primary care funding to be opened up to the competitive market.
The GPC warned there were signs that the Government was looking to push for local enhanced services to be provided by alternative providers through any qualified provider, and that any change to current arrangements would fragment patient care, and strip practices of valuable resources.
Responsibility for commissioning LESs will be handed to CCGs from next April, with Pulse revealing back in October that swathes of general practice funding could be under threat if services become subject to the same competition rules as some secondary care services.
Commissioning leaders recently helped force the Government into a U-turn on the use of AQP to allow CCGs decide if and when they use competition.
But the GPC said the Government had indicated to them that they may change the name of LESs, raising concern that the emphasis may shift away from practices, and that pressure may be placed on CCGs from the centre to open enhanced services up to alternative providers under AQP.
The GPC acknowledged due probity was required to ensure CCGs were not open to accusations of conflicts of interest, but said it was important that CCGs did not feel compelled to take services out of the practice
GPC chair Dr Laurence Buckman said: ‘We are concerned there will be a push to put [LESs] out to the private sector, and there is no reason why that should be.
‘The Government wants to change the name slightly. We are worried that a name changes carries with it an implication that it is no longer going to be locally managed.’
‘People do not need to flog off every service to the private sector – any service that can be delivered by GPs in the locality should be done if that’s possible.
Dr Buckman added: ‘If you say they have got to be tendered out, what you’ve just done is fragmented services for patients. Slowly you slice bits of general practice, and you make that less viable. Even more importantly, you are making care less coherent for the patient.
‘There are many services that GPs offer that only GPs can offer, because it relies on a fact that you’ve got a practice list.’
GPC negotiator Dr Chaand Nagpaul said it would be appropriate for CCGs to commission practices to continue providing LESs, as long as they were subject to external scrutiny.
He said: ‘We obviously want to have a process that demonstrates probity and that decisions were made for the right reasons. An external scrutiny body should be available to every CCG to legitimise the decision to commission services from their local GP practices.’