Consortia must not hold GP contracts

GPs want assurances they will not be expelled from consortia or lose their contracts when the profession takes over commissioning, a GP/NHS Alliance poll reveals.

Dr Michael Dixon: 'GPs must see consortia as their friends. The NHS Alliance feels very strongly about this' (Photograph: Mike Alsford)

The survey, of 262 GPs, found 65 per cent do not think consortia should be able to expel practices for missing prescribing or referral targets.

A similar proportion (63 per cent) say practices should not lose their contracts if they are expelled from or not accepted into a consortium.

Conflicting visions of the relationship between consortia and their member practices have emerged during the White Paper consultation.

The GPC believes consortia should not hold GP contracts, and the NHS Alliance agrees, warning that the groups should be 'true collectives, not local enforcers'. The National Association of Primary Care, however, has called for consortia to hold practice contracts to limit the bureaucracy of the central NHS Commissioning Board and allow consortia more freedom to design local services.

Sixty per cent of the GP respondents to our survey agree with the White Paper vision for the commissioning board to hold GP contracts. A quarter think GP consortia should be responsible, while the rest of respondents were unsure.

NHS Alliance chairman Dr Michael Dixon said it was important consortia do not hold practice contracts or become 'another version of PCTs'.

'GPs must see consortia as their friends. The NHS Alliance feels very strongly about this,' he said. 'We don't want a Lord of the Flies situation between GPs, sacking each other.'

GPC negotiator Dr Chaand Nagpaul said it was 'premature and alarmist' to discuss expulsion from practices. 'GPs have worked in collaborative arrangements before. A successful consortium will find other methods of helping practices to achieve standards,' he said.

Overall, the GP/NHS Alliance poll reveals growing support for the White Paper.

A total of 10 per cent of GPs describe themselves as 'enthusiastic', and 38 per cent say they support the concept but want more detail. More than half of GPs are now in a consortium or commissioning group.


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