DoH stance cuts commissioners' freedom

A DoH crackdown on methods PCTs use to cut referral costs could leave GP commissioners unable to plan services effectively, NHS experts fear.

Andrew Lansley: no minimum waits or operation caps (Photograph: P Hill)

Health secretary Andrew Lansley this week announced a ban on PCTs enforcing minimum waiting times on referrals and placing caps on operations.

Mr Lansley was responding to a report published this year by an NHS watchdog, the Co-operation and Competition Panel, which said that increasing waiting times for patients could 'save money overall'.

But Mr Lansley announced that by March 2012 at the latest, all PCTs would be expected to remove minimum waiting times and caps on operations. The DoH said that all decisions that could impact on patient choice must now be taken at PCT board level and must be made public.

NHS Confederation chief executive Mike Farrar said it was critical that clinical commissioning groups (CCGs) retain 'absolute control' over referral and admission thresholds. 'Otherwise they will find it difficult to balance their budgets,' he warned.

Elizabeth Wade, head of commissioning policy for the NHS Confederation's PCT Network, added: 'If the government intends to take action to prevent commissioners being able to take such decisions about local priorities, it must set out clearly how and under what circumstances such action will be taken, and acknowledge the impact this will have on PCTs, and new clinical commissioners' ability to plan services for their communities.'

Ms Wade said that changing commissioning structures within the NHS would not alleviate financial pressures. 'Everyone needs to be clear about this,' she said.

Dr Shane Gordon, NHS Alliance GP commissioning federation national co-lead, said the ruling would inevitably leave CCGs making tough financial decisions.

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