Sir David Nicholson told the National Association of Primary Care (NAPC) conference in Birmingham that the DoH was discussing proposals for consortia to hold GP contracts as a way to drive up standards.
But he said ‘peer pressure’ alone was an effective tool in primary care. Sir David predicted that the DoH official report on the White Paper consultation would contain ‘very few surprises’ as there had been broad support for most of the proposals from many organisations that responded.
‘The general thrust of the White Paper, I can see being taken forward,’ he said.
Sir David said details of management allowances for consortia would be published in the NHS Operating Framework in December. He said he was pushing for the allowance to be ‘as large as possible’.
The NHS chief executive predicted that the number of management posts in the NHS would fall from 100,000 to between 50,000 and 60,000 as a result of the NHS reforms. But he warned that consortia must re-employ many current PCT staff. It could cost consortia up to £1.5bn to ‘go out to other sectors and organisations’ to hire management support, he said.
Sir David insisted the reforms must not re-create existing structures. ‘If we end up with a re-badged set of organisations that would be a scandalous waste of time and skill,’ he said.