Hunt: CCGs should determine primary care commissioning

Health secretary Jeremy Hunt has signaled a shift towards handing CCGs greater control of primary care commissioning.

DH: CCGs can play greater primary care design role

Mr Hunt told a conference on the future of primary care at the King’s Fund think tank in London that he would like to see CCGs and NHS England area teams working ‘hand-in-glove’ so that primary care is commissioned ‘in exactly the way CCGs want in their area’.

Mr Hunt was responding to a question by King’s Fund’s chief executive Professor Chris Ham, who asked whether the health secretary could offer any hope for GP commissioners who would like more say over primary medical care.

Mr Hunt said it was a central issue the government needed to resolve.

While there was need for care over conflicts of interest, Mr Hunt said, commissioning would not work if area teams and CCGs operated in silos. ‘We need to find a way of encouraging or requiring them to work together.’

Mr Hunt's comments followed those by Dr Mike Bewick, who is running NHS England’s consultation on the future of primary care. Speaking earlier at the same event, Dr Bewick repeated his view that CCGs and area teams must be brought together.

‘CCGs are not in a position to commission primary care. And I think we might need to change that. Not that they’ll have the primary role to do so, but certainly the primary responsibility to work with area teams to do so. And to do more than looking at quality, but around system redesign. I don’t know how we are going to do it unless those two come together. I’m not reforming PCTs, I’m talking about how you harmonise the system.’

Mr Hunt set out in the greatest detail so far his plans to make named GPs responsible for round the clock care of elderly vulnerable patients from next April. Mr Hunt said he was confident that necessary changes to the GP contract could be made in time.

In the discussion following his speech, Mr Hunt reiterated that he wanted funding diverted from secondary to primary care. But when challenged by a practice manager over how proposals for new GP services would be funded, Mr Hunt admitted he did not have an answer.

While savings made from a more proactive model could be reinvested, he acknowledged practices needed upfront funding. ‘But I don’t pretend to have an answer to that problem now, it’s something we need to wrestle with and get a solution,' he said.

But, Mr Hunt also acknowledged there had been underinvestment in primary care compared with hospitals.

He said investment in secondary care making it easier to see a doctor at A&E, combined with lack of investment in primary care, making it difficult to see a GP, lead to the ‘imbalance we’ve now got’.

Mr Hunt said in the short term, before GP numbers could be increased, capacity could be expanded through better use of practice nurses and ‘lay people’, such as trained receptionists.

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