Speaking at a meeting of 150 CCG leaders in London on Tuesday, Mr Lansley said: ‘Let’s focus on results. I’m giving you autonomy but I’m asking you to be accountable for two things: results and achieving them within the resources available. They’re two very hard things, to consistently improve results in the next five to 10 years without 6 or 7% real-terms increases.
‘I think the evidence is already there of a comparable NHS delivering improving results with modest increase in real-terms in spending.’
Mr Lansley cited examples including a drop in GP referrals and a flattening out of A and E attendances.
NHS Alliance chairman Dr Michael Dixon said: ‘I counted the use of the word autonomy 10 times within the health secretary’s speech. It’s music to our ears.’
Mr Lansley explained how the funding formula for CCGs would change with a greater emphasis on population age rather than deprivation. He said there had been no evidence that PCTs with deprived populations spent more on public health. Future funding for public health would be given to local authorities. Funding for CCGs would focus instead on disease burden, with age being a factor likely to increase demand for NHS services.
Mr Lansley explained how he did not want to turn GPs into managers. He said PCT managers often talked to hospital managers about activity levels when what mattered to patients was GP opinion about how clinical pathways should work. Mr Lansley said: ‘If we turned you into managers we’d see the same conversations we’ve always had.’
Dr Howard Stoate, Bexley Clinical Commissioning Cabinet chairman in south east London, asked whether CCGs role in transformational change would inevitably lead to large scale destabilisation of secondary care.
Mr Lansley said: ‘Clinical redesign can lead to reconfiguration. Who is likely to take the public with them? If the local authority and clinical community have a shared view of what is the right direction to go even if you are changing services I think the chance of successes are far higher.’