Services open to 'any qualified provider' revealed by DH

The DH has revealed a list of 39 services that it plans to allow any qualified provider (AQP) to deliver from this autumn.

Dr Richard Vautrey: APQ will lead to fragmentation of services

The services which include some child and adolescent mental health services, diagnostics and weight management, are set to be put out to AQP through PCTs this autumn. A spokesman for the DH could not give a more specific date and said contract details are still being worked on by commissioners.

He said: ‘The NHS is firmly on track to offer patients the choice of AQP for a range of community and mental health services from this autumn. Commissioners are finalising their plans with healthcare providers and services have been advertised. The process of qualifying potential providers is well underway, with some now already able to offer care that meets local need.’

If a service is put out to AQP, providers can be from the NHS, private or voluntary sectors. It leaves the patient to choose the provider of their care from a list, all of which have to be Choose and Book compliant.

GPC deputy chairman Dr Richard Vautrey said: ‘This list only goes to show how top-down this process is and how little real choice clinical commissioning groups (CCGs), GPs or indeed patients have. It will lead to greater fragmentation of services which could potentially undermine patient safety.

‘It's difficult to comment without knowing exactly what is meant by the various headings. For instance dermatology could cover a whole department from the basic primary care elements to specialised tertiary service. We'd need to see a lot more detail to understand what impact this would have.’

From next April England’s 212 CCGs will have to open up some services to AQP. But a list of 39 services (see below) are expected to be put out to AQP before PCTs hand over commissioning responsibility to CCGs.

The DH has previously said services put out to AQP will remain free for patients to use and that access will be based on clinical need, in line with the NHS Constitution. It has said that there is nothing to stop CCGs from commissioning certain services from GP practices but that there needs to be a separation between the commissioner and the provider function of the GP practice.

GPs are reminded by the DH to refer patients in line with the GMC’s Good Medical Practice on managing conflicts of interest. The guidance reads: ‘If you have a financial or commercial interest in an organisation to which you plan to refer a patient for treatment or investigation, you must tell the patient about your interest. When treating NHS patients you must also tell the healthcare purchaser.’

List of services due to be put out to AQP this autumn

  • ADHD and autism
  • Adult hearing
  • Anti coagulation
  • Child and adolescent mental health services (CAMHS) tier 2
  • Community cardiac diagnosis
  • Community fracture clinic
  • Continence
  • Continuing care
  • Continuing care (children)
  • Continuing care adults
  • Continuing care other
  • Core nail surgery
  • CT
  • Dermatology
  • Diabetes education and self management for ongoing and newly diagnosed (DESMOND)
  • Dual-energy X-ray absorptiometry (DXA, previously DEXA)
  • Diabetes education
  • Diagnostics
  • ECG
  • Endoscopy
  • Glaucoma
  • Lymphoedema
  • Mental health spot placements
  • Minor oral surgery
  • MRI
  • Musculoskeletal (MSK)
  • MSK carpal tunnel management
  • Non-Ostetric ultrasound
  • Ophthalmology
  • Pain services
  • Podiatry
  • Psychological therapies
  • Smoking cessation
  • Supported accommodation
  • Termination of pregnancy
  • Vasectomy
  • Venous leg ulcers
  • Weight management
  • Wheelchairs

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