BMA legal adviser and barrister Shanee Baker told a Londonwide LMCs conference in London on Thursday that CCGs had the power to refer ‘unruly’ practices to the NHS Commissioning Board (NHSCB).
Currently there was ‘not very much’ the NHSCB could do to discipline practices that failed to abide by their constitutions, she said.
However, she warned there was potential for a clause to be added to the GMS contract meaning practices that breached their CCG constitution would also be in breach of their core contract and could be served with a notice of termination.
‘There is a potential, and I emphasise the word "potential", link between breach of a member's obligations under their CCG constitution and breach of core contract terms and conditions,’ Ms Baker warned.
The GMS contract change would reflect section 28 of the Health and Social Care Act, Ms Baker said. Two of the four points in this section of the Act have already been added to the GMS deal, she said, requiring practices to have a representative to attend CCG meetings and to advise the CCG who that representative is.
The remaining two elements of section 28 were ‘a little bit more uncomfortable’ for the BMA, Ms Baker said. ‘The last two essentially said that a CCG member would have to support its CCG and would have to abide by the commissioning decisions of its CCG.
‘If those two bullet points were inserted into the GMS contract it would mean that if a CCG member practice was in breach of its obligations under its CCG constitution, that would automatically be a breach of core contract terms and conditions under GMS, PMS and APMS.
‘And that could go through the grievance and disciplinary procedures already set out in the core contract and could lead to things like remedial notices, termination notices, etc.’
Ms Baker said that for the time being the DH had not set out plans to add the two clauses into the GMS contract. But she warned there was potential for it to do so in the future.
‘Section 28 has not been deleted from the Act. And it’s probably going to be that they are going to wait and see what happens after 1 April, to see how much cooperation there is out there between practices and their CCGs. We are hoping those points won't go in.’