The health secretary has written to leaders of prospective CCGs outlining three key pledges. While the National Association of Primary Care (NAPC) and NHS Alliance which make up the Clinical Commissioning Coalition (CCC) welcomed Mr Lansley’s letter, GPs are not as optimistic about the explanations.
GPC negotiator Dr Chaand Nagpaul said: ‘I don’t think this letter actually takes us any further forward in terms of addressing the fundamental issues GPs object to. Privatised commissioning, commercialisation and fragmentation of care haven’t been addressed. The words in the letter are broad-brush aspirations with no detail.’
The first of Mr Lansley’s pledges stated that CCGs will have the freedom to commission services in ways that ‘meet the best interests’ of patients. The groups can choose to continue to work with existing providers or commission new services to address any weaknesses.
Mr Lansley also pledged that CCGs will have the freedom to work with whichever sector they prefer in commissioning health services. He highlighted the fact that no one will be ‘forced to use private sector commissioning support services’.
Dr Charles Alessi, NAPC chairman and senior member of the CCC, said the CCC appreciated the clarification on tendering. He added: ‘This letter makes the position very clear. CCGs, and CCGs alone, will decide when and how competition, if at all, should be used in the interest of patients. Competition is not necessarily about the use of private sector providers; many forget that competition is possible within the NHS, between one NHS trust and other trusts.’
The third point the health secretary stressed was that CCGs will have legal responsibility for their NHS budget and commissioning decisions. Mr Lansley wrote: ‘The NHS Commissioning Board will hold you to account for the outcomes you deliver within the resources given to you, but will be responsible for promoting autonomy in how you achieve these outcomes.’ Clinical senates will provide strategic advice but will not interfere with the daily running or performance management of CCGs.
Dr Nagpaul said: ‘It has been said that there will be no top-down control, but the whole structure is putting disproportionate emphasis on the NHS Commissioning Board. The NHS landscape will be highly weighted towards large commissioning organisations and the NHS Commissioning Board. GPs don’t feel particularly empowered to have local control.’
- GP magazine is a media partner for Commissioning 2012, an event in London on 27-28 June featuring over 700 GPs and primary care managers. Speakers are expected to include health secretary Andrew Lansley and NHS chief executive Sir David Nicholson.