LMC Conference 2014: GPs reject CCG primary care commissioning role

CCGs should not co-commission GP contracts because of 'unacceptable' conflicts of interest and the risk it may undermine their credibility, GP leaders have said.

LMC conference: CCG primary care control rejected
LMC conference: CCG primary care control rejected

LMCs said proposals by NHS England for CCGs to co-commission GP contracts will 'fatally damage relations between CCGs and their constituents', and reduce CCGs' chances of effectively commissioning other areas of care.

A motion rejecting these plans, outlined in NHS England's 'Call to Action' interim response, was passed at the UK LMCs annual conference of representatives in York on Thursday.

Dr Aneel Bilkhu, Nottinghamshire LMC, said the proposal 'threatens to create a fissure which could be fatal to the good working relationships with GPs on which CCGs' success depends'.

History repeating itself

He said the drive to encourage CCGs to sign up to co-commission primary care 'sounds remarkably like what happened to PCGs, when they were encouraged to become PCTs, and there is a real risk of history repeating itself'.

He suggested that, if this move is inevitable, more support should be given to help GP practices become more resilient to huge organisational changes.

But he said the decision to proceed could be 'fatal' to CCGs' ambitions of creating more efficient and responsive services.

Dr Mitch Garsin from Hillington LMC described CCG co-commissioning of GP contracts as 'the ultimate poisoned chalice'.

He warned that it would be 'inconceivable that any GP on the governing bodies would be allowed any sort of influence, let alone rights, on any decision about the future of general practice in their area'.

No clinical leadership

'Decisions about our practices, our patients, our livelihoods, would be taken not by the statutory body NHS England, not even by elected members of governing body. But by a rump of that board, unelected managers, lay members, and secondary care members, all GPs having been excluded from the debate due to their palpable conflicts of interest. Where is the clinical leadership in that?'

Dr Barry Moyse from Somerset LMC said there may still be advantages to be found from co-commissioning, and questioned the 'absolutist' language of the motion.

But Dr Simon Parton from Lewisham LMC said passing GP contracting work onto CCGs which are already overstretched was 'a recipe for disaster'. 

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