Guest Opinion: Dr Elizabeth Johnston - CCGs need to avoid conflicts of interest

Asked what has been the biggest benefit of CCGs compared with PCTs, my answer is always that CCGs have increased the engagement of GPs in improving local health services.

This was shown after reflecting on a meeting where we commended GPs on their use of admission avoidance schemes, which means our non-elective reduction scheme of one less avoidable hospital admission a day is on track.

Whenever we ask GPs for views from the public on local services, they usually write a comment about their own GP surgery, which is not a surprise as that is where most NHS activity (as opposed to cost) occurs. The most common theme in those comments is access to appointments.

At those meetings there is a well-used phrase: 'CCGs do not have the budget for primary care commissioning.' At present, CCGs have a statutory responsibility to support NHS England to improve the quality of primary medical care.

I can confirm in the past seven months, the area team has contacted the CCG for the local view of changes or problems involving two of our 20 practices. Both conversations were constructive. So with 95% of the practices in my CCG regularly attending monthly meetings, engagement is going well. But how would member practices feel about their CCG having joint responsibility with NHS England for commissioning their services?

CCGs know their communities and are well placed to give a view on strengths, opportunities, threats and challenges facing local practices.

However, the GP and practice managers on the CCG board are elected by the GP members, so if the CCG were to share the responsibility for services, the potential conflicts of interest would need to be carefully considered.

Nevertheless, if transformational change is to occur in primary care to meet the increasing demands on services in the community, local clinical leaders will be best placed to lead the changes, but this will need to be co-ordinated with the area team as part of the required governance, given the potential conflicts of interest.

  • Dr Johnston is chairwoman of South Reading CCG, Berkshire. She writes regularly for our sister website, Inside Commissioning, at insidecommissioning.co.uk

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