The King’s Fund and Nuffield Trust report found that GPs’ confidence in their ability to influence their CCG has fallen significantly since two years ago, when 35% of family doctors believed they could influence their local CCG.
The study, which has tracked the views of doctors and managers in six CCGs since their creation in 2012, also found that less than a quarter of GPs currently felt they ‘owned’ the CCGs, down from 36% two years ago.
GPs also felt CCG managers had more influence on commissioning decisions than doctors, and that GPs had seen little or no change in the quality of care in general practice since the introduction of CCGs.
CCG managers told the survey that they were not given the autonomy they needed to involve GPs effectively in designing local services; that budget cuts were making it difficult to develop a high-quality, clinically-led, commissioning function; and that they were not getting political support when financial pressures meant they had to take potentially unpopular decisions.
The report calls on commissioners to engage with all GPs in their area through better communication, including face-to-face meetings; to develop the next generation of GP leaders by creating roles that allow GPs to test the water before taking on clinical lead roles; and by maximising the contribution of GPs by refining CCG structures to focus GP time on areas where it counts most.
The report recommends that the DH and NHS England should ensure that GP clinical leaders are given the support and training they need to do their job properly; that the royal colleges should work with government to promote commissioning as a valid career among doctors; and that CCGs’ role in developing new models of care (including at-scale working in primary care) should be made clear.
Dr Amanda Doyle, co-chair of NHS Clinical Commissioners and chief clinical officer of NHS Blackpool CCG, highlighted the fact that the report found that CCGs had secured better engagement with GPs than previous commissioning models.
‘As a CCG leader and a GP myself I recognise the challenges and pressures that come with balancing both roles, and we know there is more to do to make sure even more GP colleagues and other clinicians feel able to actively participate in the clinical commissioning process,’ she said.
The NHSCC also backed a suggestion contained in the report that the moratorium on CCG mergers should be ended.