2 June 2011

Breaking Through - How GP-Led Consortia Can Unlock The Full Potential of The NHS

Dr Michael Dixon, chairman of the NHS Alliance, today called on the Government to speed up the process of NHS reform in areas where GP-led consortia are ready, willing and able to get on with the job of improving services for patients.

The Alliance will today publish Making It Better, a paper explaining how GP-led consortia can unlock the full potential of the NHS.

The paper includes six case studies showing what consortia are doing already to improve outcomes for patients and increase the productivity of the NHS. The studies demonstrate how patients will benefit when the consortia take over responsibility for commissioning on a much bigger scale.

The paper sets out 10 good reasons why GPs are well placed to make decisions about how local healthcare services should be organised.

Dr Dixon said: “We are hearing a lot about delay in reforming the NHS. But delay in the parliamentary progress of the Health and Social Care Bill need not mean delay on the ground. Across England, there are dozens of GP-led consortia that are ready, willing and able to take increasing responsibility for commissioning NHS services for their patients. They have broken through the credibility barrier that has held back clinically led commissioning for too many years. Their enthusiasm must not be wasted.

“We don’t want to impose change on areas where the consortia are not yet ready. But if the whole convoy waits for the slowest ship, we will all be sunk.”

Dr Dixon called on Sir David Nicholson, chief executive of the NHS in England, to issue guidance to Primary Care Trusts to allow pathfinder consortia that are ready, willing and able to take on commissioning responsibility as soon as possible. Dr Dixon said: “We are raring to go. If the NHS is to deliver greater efficiency, better health outcomes and more patient satisfaction, we have no time to lose.”

10 good reasons

Below is a summary of the 10 good reasons for giving GP-led consortia responsibility for commissioning.

  1. GPs know the patients and the routes along which patients are directed as they move through different hospital departments towards discharge, rehabilitation and aftercare.
  2. Their knowledge puts GPs in a position to innovate and improve the service. They know when patients have to go to hospital for care that could perfectly well be organised nearer home, or even in the home.
  3. Doctors, nurses and others working in general practice are used to acting as advocates for individual patients, but they are also in the ideal place to be advocates for the population as a whole.
  4. GPs are qualified by years of professional training to talk to hospital consultants on more or less equal terms. They are much better equipped than PCT managers to understand the risks of alternative courses of action.
  5. Perhaps even more crucially, GPs can talk to other GPs on equal terms. When GPs are in charge, other GPs are more likely to investigate why they might be spending more than average on drugs or referrals to hospital.
  6. GPs are part of a primary care team, including practice managers, nurses, therapists, pharmacists and receptionists. They are better placed than anyone to know if people are falling into the cracks between health, social care and the charitable sector.
  7. Doctors are trusted. The latest opinion poll results showed 92% of British adults said they would trust doctors to tell the truth – a much higher score than for other professions.
  8. Since the foundation of the NHS in 1948, most GPs have been independent contractors who were responsible for running the business side of their practices. Many GPs are well used to working in partnership with managers.
  9. Only a small fraction of the cost to the NHS of running a GP practice goes to the GPs for salaries and overheads. The big money is spent on what the GPs decide to do for their patients, including referrals to hospital, diagnostic tests and prescription costs. It is not good enough to leave the GPs as providers with every incentive to increase their own income, but no incentive to make best value of the NHS’s overall investment.
  10. GP commissioning is now the best hope for the health service. It can be seen as the third way. It avoids the mistakes of bureaucratic state control on the one side and the anarchy of market competition on the other. For that to work, GPs will need to extend their role from looking after each patient in front of them to also being responsible for improving the health and services for all local people.

Notes:

  1. For a copy of the document, please email pressoffice@nhsalliance.org or call 07772756674.
  2. NHS Alliance brings together GP consortia, PCTs, clinicians and managers as the leading organisation in primary care. We are an independent non-political membership organisation proud to be at the forefront of clinically-led commissioning. Its leaders are all dedicated professionals, who represent the Alliance’s diverse membership, working ceaselessly to meet the challenges facing the NHS today. Find out more at www.nhsalliance.org
  3. The NHS Alliance Annual Conference – Break Through! – will be held on 30/11 - 1/12 in Manchester.