The announcement of the devolution experiment in Greater Manchester this year was a surprise to many, not least the area’s GPs
And when the profession was initially locked out of talks, it took an extraordinary GP leader to batter down the door and ensure GPs were involved in the decision making.
But Dr Tracey Vell is not your average LMC leader. She made her name by strongly arguing that the flagship seven-day access pilots in her area – the inspiration for the Prime Minister’s election manifesto – were a waste of resources and she has since worked with local commissioners to make those plans more acceptable to GPs.
And it is this approach that has ensured that GPs have a say as local authorities in Manchester prepare to take control over the region’s £6bn NHS budget.
She told Pulse that she had been forced to explain that if the plans involved a ‘transformation’ of primary care, the main providers of that care should have a say.
‘At first, I spent most of the time just highlighting the differences between GPs who work for CCGs, work for federations, work in practices, registrars, salaried GPs and locums. I also had to explain that the LMC is a statutory body supporting the whole of general practice, and that we are here not just to solve problems, but actually to be strategic. That is still a difficult one for people to understand, and some days I feel I am still swimming against the tide,’ she says.
And as a result, the past few months have been taken up with discussions with [NHS chief executive] Simon Stevens, speaking at primary care summits in Greater Manchester and ‘having an interesting debate on BBC Breakfast’ about the project known colloquially as ‘DevoManc’.
Dr Vell says the LMC’s influence has meant her opposition to the seven-day access pilots has softened. ‘Seven-day access now works as a bigger part of a jigsaw, instead of an add-on. We need to make sure we don’t overextend practices, and deal with out-of-hours access as a commissioned non-core service, not a responsibility for practices.’
But she adds: ‘I still have issues around duplicating resources. Why are we extending core hours when we already have fantastic out-of-hours services?’ As ever, Dr Vell speaks complete sense.