King's Fund calls for gradual introduction of GP commissioning

The White Paper reforms could disrupt patient care unless they are rolled out in a more measured way, according to the King's Fund.

Prof Ham: ministers should think again about how GP commissioning is implemented
Prof Ham: ministers should think again about how GP commissioning is implemented

The influential think-tank is the latest body to criticise the scale and pace of the reforms, after the RCGP issued similar warnings earlier this week.

In its response to the White Paper consultation, the King’s Fund ‘strongly supports the government’s aims’ but questions whether such fundamental reforms are appropriate.

‘The case for reorganising the NHS needs to be clear and convincing to justify taking these risks, and this case has not been made,’ the report says.

In the report, a number of different ‘scenarios’ predict how GP commissioning might look over the next few years.

The ‘most pessimistic’ paints a bleak picture where ‘consortia are unable to control expenditure and lose control of their budgets.’

Another scenario imagines ‘chains of GP consortia aligned to large private insurance companies, who help them to manage financial and insurance risks associated with their enrolees.’

A third suggests GP consortia will ‘in effect look like PCTs but perhaps with more clinical or GP leadership. They will attempt to manage the activities of member practices, who will distrust those GPs who have gone over to the other side (much as they regard PCTs now).’

The report suggests existing GP commissioning is strengthened and trialled, with consortia gradually taking over from PCTs, rather than the imposition of the consortium model across the whole country in 2013.

King's Fund chief executive, Professor Chris Ham, said he hoped ministers would 'think again,' about how the proposals are implimented.

'This does not mean putting the brakes on across the board. In some areas, they could in fact move more quickly by beginning to test out and evaluate how key elements of the reforms will work in practice.’

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