No consortia budgets until 2013

GPs have warned that consortia will be stuck in limbo until the DoH confirms their statutory duties and funding, as a DoH adviser confirmed their income may not be finalised until 2013.

Dame Barbara: The allocation formula will be different to what it looks like now
Dame Barbara: The allocation formula will be different to what it looks like now

Delegates at an NHS Alliance White Paper event in London last week said plans for their consortia's size and structure had stalled because they have no idea of their budgets and responsibilities.

But the funding formula for GP consortia may not be confirmed until 2013, according to Dr James Kingsland, National Association of Primary Care president and DoH national clinical lead for practice-based commissioning.

Funding for consortia was thrown into further doubt last week after DoH director of commissioning development Dame Barbara Hakin told the White Paper event that the funding formula would 'move gently' from the system used for PCTs.

'We are working through the allocations formula model but it will be somewhat different to what it looks like now,' she added.

Consortia will also face a cap on the proportion of their budget that can be spent on management under DoH plans to cut NHS management costs by 45 per cent, she said.

During questions from delegates, Dame Barbara, also lead GMS contract negotiator for NHS Employers, suggested the contract may not have to change much this year to accommodate GPs' new duties.

'The GP contract already makes it clear GPs have a responsibility to provide the best care and not to be wasteful of resources,' she said.

'An unnecessary referral is a wasted resource. We are not talking about much else here.'

Accountability arrangements and size of consortia 'really is up to you to decide,' she told GPs, practice managers and PCT staff at the conference.

Claire Boraston, commissioning lead at the Canterbury and Coastal Commissioning Consortium in Kent, said consortia were making good progress but urgently needed more information: 'Consortia need to know what the statutory duties are as soon as possible so we can start planning how we meet them.'

One GP from King's Cross, London, said his consortium was 'up and running and ready' but 'needs to know if we will be faced with our PCT's deficits'. 'We need to see how much money we have before we know if our size is appropriate,' he said.

Another workshop delegate said capping the amount consortia could spend on management was 'perverse'. 'Why put a limit on how much you can invest if it may save money in the long-term?' he asked.

Afterwards, a DoH spokesman would only confirm what the White Paper states - that consortia will be allocated practice-level budgets directly, based on disease burden in the area.

But Dr Kingsland said it was unlikely budgets for GP consortia would be finalised until PCTs are abolished in 2013. 'The 2013 date was set not to give consortia time to get up and running, but because it will take that long to come up with a fair formula.'

He said statutory duties were unlikely to be known until the Health Bill begins its passage through parliament next month.

'It could take until next spring,' he said. 'I say channel all that enthusiasm and entrepreneurial effort into looking at the sort of patient services you are going to focus on.'

This week NHS chief executive Sir David Nicholson wrote to managers stating that running costs of new consortia must 'start and remain low'.

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