McKinsey fears consortia management funding will be too small

Management consultants have expressed doubts that GP consortia will be able to cope with drastically reduced management costs set by the DoH.

In a discussion paper on GP commissioning, consultants McKinsey argue that if consortia’s management allowance is around £10 per patient, as predicted, they will face staff shortages.

‘Commissioning costs today are £60 to £90 per head,’ the report says. ‘Of this, our analysis suggests around £37 will be borne by consortia, with the rest falling to others.

‘Current speculation is that the management allowance will be £10 per patient – challenging to achieve, even if consortia reduce commissioning costs substantially. £10 per capita would fund around 35 staff for a population of 250k, costing £2.5m. PCTs today have 200 staff for the same population.’

Although the DoH has not confirmed how much the management allowance will be, NHS chief executive has made it clear they will be significantly less than PCTs receive.

The cost of releasing time for a clinician would add to the problem, say the report’s authors.

‘Additionally, there are the costs of being an accountable, clinically-led, organisation. PCT Boards cost about £0.5m to £1m.

‘Releasing time for a clinical director, five clinical leads and sessions for other clinicians [could cost] £800,000 to £1.5m, which alone would require a population of 80,000 to 150,000 to cover.’

The report says the larger the consortia, the less likely it will fall into deficit. ‘At a size of one million (people) no consortium would be likely to run a deficit above 1%,’ it recommends. ‘If consortia each have 100,000 patients, about 4% of them would run a deficit greater than 2% of total budget.’

Many consortia are considering ‘multi-tier’ arrangements involving small consortia (30-50,000 patients) grouped together with a population of up to a million.

‘This should provide enough scale to commission acute services well, keeps management costs per head low and manages risk effectively, while retaining the responsiveness of local arrangements,’ it says.

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

GPs delivered huge rise in face-to-face consultations in week before NHS England letter

GPs delivered huge rise in face-to-face consultations in week before NHS England letter

GPs delivered a huge increase in face-to-face appointments in the week before NHS...

RCGP facing legal action over stance on assisted dying

RCGP facing legal action over stance on assisted dying

The RCGP is facing legal action over its decision to remain opposed to assisted dying...

Medeconomics Live aims to help practices thrive under the new GP contract

Medeconomics Live aims to help practices thrive under the new GP contract

The one-day, virtual Medeconomics Live conference aims to provide practices with...

GPs face wave of abuse and complaints after NHS England face-to-face appointments claims

GPs face wave of abuse and complaints after NHS England face-to-face appointments claims

GP practices have faced a wave of abuse and complaints after a letter from NHS England...

Government denies plan to make GPs 'gatekeepers' of COVID-19 testing

Government denies plan to make GPs 'gatekeepers' of COVID-19 testing

The government has denied plans to make GPs 'gatekeepers' of the struggling COVID-19...

Expansion of NHS 111 service could see direct GP booking extended

Expansion of NHS 111 service could see direct GP booking extended

Plans to expand NHS 111 under measures to prepare the health service for winter could...