Large practices could hold power in consortia

GPs in large practices could be given more say in consortia decision-making than small practices, commissioning groups have suggested.

One consortium in Kent suggested GPs could be given 'one vote per 2,000 patients'. The suggestions were made at an NHS Alliance event on GP commissioning last week, where delegates discussed how relationships between consortia and their member practices might work.

One PCT manager, who asked not to be named, asked: ‘Is every GP’s opinion a vote, irrespective of what that opinion is? Or does the board decide on some GPs’ behalf?’

Delegates feared few clinicians would be prepared to be accountable officers in consortia, with full responsibility for financial balance and quality.

One PCT representative from the east of England said he could only find ‘a handful’ of GPs who were interested.

A PCT manager from Essex criticised LMCs for telling practices to ‘choose leaders who you don’t mind policing you’. ‘Is this best for commissioning in your area and for your patients?’ she asked.

The workshop, made up of PCT commissioners and GPs, concluded that consortia should be able to exclude practices from their consortium, even if it puts them out of business.

The feedback will be compiled into a report and handed to the DoH.

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