NAPC demands light consortia rules

The National Association of Primary Care (NAPC) will call for the NHS Commissioning Board to perform 'almost no performance management at all' on GP consortia.

Dr Alessi: 'We are moving towards a system that will be lighter on performance management' (Photograph: Jason Heath Lancy)
Dr Alessi: 'We are moving towards a system that will be lighter on performance management' (Photograph: Jason Heath Lancy)

The NAPC response to the White Paper consultation, to be published early this month, will also call for GPs to face 'financial consequences' significant enough to drive them to look at their resource use.

'We are moving towards a system that will be lighter on performance management,' NAPC executive member Dr Charles Alessi said.

'It should be possible for there to be nothing or almost nothing, between that central body (The NHS Commissioning Board) and the consortia - but of course that will be difficult to deliver.'

GP consortia will be assessed on the health outcomes of their population but should be left to achieve it in any way they like, said Dr Alessi.

Health and Well Being boards - which will link consortia with local authorities - should give feedback to the commissioning board about what is working, he added.

If commissioning is to become 'a core part of everything GPs do', GPs must face financial losses if they are not contributing, he added. 'It is clear that the way this is managed and the financial consequences must be great enough to influence what one does,' he said.

If 'only 2 per cent' of GP income depends on involvement in commissioning, this is unlikely to provide strong motivation, Dr Alessi argued.

'If it is associated with a much higher proportion of income and proportional to the degree of change in terms of outcomes, we will get more accelerated change,' he said.

Dr Alessi said general practice must become 'more corporate - more predictable', with consortia agreeing the most appropriate pathways and treatments and monitoring how well GPs stick to them.

The NAPC also recommends consortia develop 'expert groups' to make rationing decisions - using NICE guidance but reflecting local needs.

The NHS Commissioning Board should have the final say on any decision to expel a poor practice from a consortium. It should take account of feedback from the consortium, and consider how easily the practice could move to another consortium, said Dr Alessi.

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