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SHA orders commissioning group to merge

An SHA has instructed a single-practice clinical commissioning group (CCG) to merge with its neighbours despite praising its ‘excellent work’.

The Red House Group in Hertfordshire, which consists of just one practice, has been told by NHS Midlands and East that its structure was ‘not permitted’ under the health bill, and that the group was ‘very unlikely to be authorised’.

But the GP chair of the CCG hit out at the decision, claiming the Government had reneged on its white paper promise to allow GPs the freedom to innovate.

It comes after Pulse reported yesterday that dozens of CCGs could be forced to merge after the 2012/13 NHS Operating Framework set GP commissioners a management allowance of £25 a head and said that CCGs should be ‘coterminous with a single local Health and Wellbeing Board’.

The letter from the SHA – written by Dr Paul Zollinger-Read, DH pathfinder lead and director of commissioning development for NHS Midlands and East – said: ‘The SHA have been very impressed at the excellent work that The Red House has undertaken and the way in which you have embraced commissioning.’

‘However it is the view of the SHA team that in your current configuration the CCG will not meet the requirements of the Health and Social Care Bill and this is very unlikely to be authorised.’

Dr Zollinger-Read added: ‘As I am sure you are aware, a single-practice CCG is not permitted under the bill. A single practice CCG within a larger geographical area covered by one larger CCG does not meet the boundary requirement and could cause confusion for patients and partners.’

‘I would urge you very strongly to take control of your own destiny and start negotiations with your colleagues in the Herts Valley Clinical Commissioning Group as soon as possible.’

Dr Mike Ingram, a GP in Radlett, and chair of the Red House Group, said the CCG would fight the move as they believed they were more effective in their current guise, where they had met all of their QIPP targets on referrals and prescribing.

He said: ‘We want to pursue this for as long as possible and we are going to discuss this. The practice is the level where you get results. We are achieving the targets.’

Dr Ingram bemoaned what he described as the ‘top down control’ which was now dominating the authorisation process. He said: ‘We resent the fact that this is about GPs being told what to do. Flexibility was supposed to be the key. That’s something the Government has now reversed.’

Dr Ingram said he would be prepared to discuss working with other local groups, but warned: ‘We are not prepared to compromise on our principles.’

He said: ‘Our achievements have been achieved through teamwork. If that can be emulated [by working with others], then great. But I think the model we have is ethically more in tune with our GP colleagues.’