Who will influence the future of GP consortia?

Tom Ireland looks at GP representative bodies talking to the DoH.

Most pundits agree that the White Paper Liberating the NHS, while vast in scope, posed more questions than it answered.

The key detail will be thrashed out behind the scenes in meetings with the DoH and through a series of consultations.

Nearly all the major primary care organisations believe the DoH is listening to their concerns and ideas. But who has the most influence and how do they want to shape commissioning? Is every day that PCTs remain wasting money? Or should GP commissioning be piloted and phased in carefully?

DoH and Andrew Lansley

The White Paper is seen as Mr Lansley's personal project; his reputation depends on its being passed. He faces a campaign to block or slow reforms by Unison and former health secretary Andy Burnham. Success also depends on GPs' support.

What do they want?

  • Rewrite GP contract by 2013 to include commissioning.
  • Abolition of PCTs by 2013.
  • Consortia size, timetable and funding decided by consultation.


What does it want?

  • Commissioning kept out of the core GMS contract.
  • Enough funding to compensate GPs for their time but not make profit.
  • Consortia free from long-term deals signed by PCTs.
  • Freeze out private sector.
  • GPs to wait for more detail before forming consortia.

How influential?
Described as 'in the driving seat' by one former DoH health advisor. GPC/DoH contract talks beginning



What does it want?

  • GPs elected to lead consortia.
  • Commissioning to be 'less burdensome' than PBC.

How influential?
Chairman Dr Peter Swinyard feels Family Doctor Association is 'right at the centre' of DoH discussions and DoH in 'constructive listening mode'.


What does it want?

  • PCTs abolished quickly.
  • Rapid handover to GPs.
  • Believes loss of income inevitable for practices that do not commission.

How influential?
National Association of Primary Care president Dr James Kingsland is DoH national clinical lead for practice based commissioning (PBC). Profile higher under this government and strongly back White Paper.



What does it want?

  • To avoid private firms taking over consortia.
  • Failing consortia supported by NHS Commissioning Board or merged.

How influential?
Apolitical but supportive of the White Paper. Chairman Professor Steve Field in close contact with health secretary - RCGP hopes to ensure practices work well together and share data.


NHS Alliance

What does it want?

  • Smaller consortia.
  • PCT debts wiped or transferred to NHS Commissioning Board.
  • Pilots of reforms, delayed PCT abolition.
  • GPs to start forming consortia now.

How influential?
Has pushed for local clinical commissioning for years, and has regular meetings with senior DoH figures.

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