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Keep CCGs small to ensure they are accountable

In your editorial you state that there are two possible reasons why 93% of all elections for GP board positions were uncontested – lack of awareness or lack of engagement.

Might I suggest a third?

In commissioning groups that are small and local, like ours in Derwentside, County Durham, GP practices have been used to working together since PCTs were first introduced.

We have regular meetings between doctors from all the practices, and know each other very well. The same is true of our practice managers.

In these circumstances, it is quite possible to agree informally who should be on the commissioning board.

All doctors and practices were offered the chance to participate, and although there were more volunteers than were needed, formal elections proved unnecessary.

I believe that the reforms will only be successful if the commissioning groups are kept small, so that peer pressure can be exerted between practices.

The drive to larger groups will result in practices feeling less involved and less willing to change referral or prescribing behaviours. It is also unnecessary, as risks could easily be shared between a number of small groups.

From Dr John Young

Consett, County Durham