Editorial: CCGs should fund unresourced services

This fortnight's edition of GP reveals the extent to which practices are currently performing enhanced services for free (page 6 and 7).

The most common are for ECG recording, spirometry, phlebotomy and 24-hour ambulatory BP monitoring. Recent BMA guidance gave practices details of how they could refuse inappropriately referred workload (GP, 9 February).

Practices, the guidance says, should use their membership to require CCGs to develop policies and specifications with providers that make the scope of service provision clear.

GP was recently in the audience for a central London conference organised by our sister website Inside Commissioning entitled Commissioning Primary Care 2015.

Delegates heard how federating practices could protect them from large private providers; allowed sharing of human resources, management and pay functions; but there were also no guarantees of profitability.

This month NHS England deputy medical director Dr Mike Bewick told a central London conference that QOF was becoming 'bad for health'.

A glance at the practice income figures published by the Health and Social Care Information Centre for the first time this month would show the variability in income produced by the current GP funding system.

In Bolton the CCG is investing £3.4m into a Bolton Quality Contract on top of current funding mechanisms in return for hitting key performance indicators that would bring all practices up to £95 per weighted patient.

It is an interesting idea and illustrates how co-commissioning of primary care could be tackled creatively by CCGs.

A commenter in our survey says: 'We will drop all services that have been funded when the funding is stopped. The days of continuing to provide services that aren't funded out of the goodness of our hearts are over. The goodwill has gone.'

It is for CCGs to fund unresourced primary care that is needed, as it will be CCGs who will ultimately have to answer to patients about why services are no longer available to them.

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