The NHS Alliance and the National Association of Primary Care (NAPC) have raised concerns that many PCTs were preventing emerging clinical commissioning groups from being establishing ‘from the bottom up’.
NAPC chairman Dr Johnny Marshall said he was ‘deeply concerned’ that ‘less progressive’ PCTs were insisting that clinical commissioning groups cover a particular geography.
He said: ‘We cannot tolerate a situation where PCTs are allowed to impose their own ideas on the emerging clinical commissioning groups.
‘We fully understand the need to contain running costs within the available resources and to ensure joined up planning with local authorities but this can be achieved in creative ways, such as by clinical commissioning groups working together to share their overheads, rather than duplicating them.’
The NHS Alliance and NAPC also warned that forcing clinical commissioning groups to take on existing PCT commissioning support arrangements would stifle the enthusiasm and commitment of clinicians.
NHS Alliance chairman Dr Michael Dixon said: ‘We believe the very survival of clinical commissioning is at stake here - we do not support clinical commissioning arrangements being determined on behalf of GP practices by PCTs.
‘Unless all PCTs adopt the practices of the most progressive PCTs then they will put the success of the whole NHS at risk.’
The warnings came as a discussion paper published jointly by the NAPC and NHS Alliance said clinical commissioning was key to improving the health of the population, reducing health inequalities and providing better care to patients.
'Clinical commissioning: securing better outcomes for the NHS and its patients' said successful clinical commissioning would result in a more ‘proactive primary care’ as clinicians will ‘not baulk at radically altering historic patterns of care’.
Dr Dixon said commissioners’ earliest priority should be to push ahead with moving services out of hospital and into the community.