Londonwide LMCs warns against CCGs forcing out practices

GPs should not engage with any attempts to use co-commissioning to get rid of 'bad' practices, the leader of London's GPs has suggested.

Dr Michelle Drage: warning over CCG role (Photo: Londonwide LMCs)
Dr Michelle Drage: warning over CCG role (Photo: Londonwide LMCs)

Londonwide LMCs’ chief executive Dr Michelle Drage told the organisation's annual conference she was not prepared to have conversations about commissioners using new powers to ‘get rid’ of those practices they believe to be poor.

GPs should be working to maximise the potential benefits from CCGs gaining primary care commissioning powers in April, Dr Drage said, including securing more funding and joined-up services.

‘But I'm not prepared to have conversations that start with: this is our opportunity to get rid of the bad guys, and girls, because, quote, we all know who they are, don't we, unquote,' she told LMC members. ‘I can tell you, that some of the people we think we know, aren't the ones who have the problems. Some of these single-handed practices that feel vulnerable at the moment are providing the best quality service that anybody could possibly provide.’

Termination of GP contracts

From April many CCGs will gain powers to performance manage and terminate GP contracts. Around a third of CCGs have applied for fully delegated powers, while others will share responsibility with NHS England. Dr Drage said there were risks and benefits from co-commissioning. ‘The potential benefits are that you can create the kinds of services that will make your life easier.

'If only the money was following the lead and the vision that you have as GPs.’

She said GPs want co-commissioning to lead to more funding and light-touch management, but feared the opposite would happen.

She added: ‘Co-commissioning has got got to lead to holistic, whole person, patient centred care. Not bits and pieces, and fragmentation of care. And it's also got to deliver cash to practices.’

The theme of the conference was building resilience for GPs in the face of increasing demand and pressures.

GP resilience campaign

Londonwide launched its GP resilience campaign in November with practical advice for GPs to take control of their workload and to push back against bureaucracy and pressures from commissioners.

Dr Drage told the conference GPs had the power through practice memberships of CCGs to challenge board decisions which affect workload and resourcing. ‘This is a situation that is different from PCTs’, she said. ‘If you challenge your board on the decisions they are making, particularity around workload, you have the power, it is time for you to use it. LMCs will support that.’

On Wednesday one of the architects of co-commissioning Dr Steve Kell warned the Commissioning Primary Care 2015 conference organised by GP's sister site Inside Commissioning, that the plans  could be derailed by politicians' failure to commit to increase NHS funding.

At the same conference NHS England's head of commissioning development said she is very disappointed that some CCGs have failed to apply for primary care co-commissioning power because of opposition from LMCs.

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