20th June 2011

Clinically-Led Commissioning Must Not Be Set Up To Fail

NHS Alliance has urged the government to ensure that clinical commissioners have sufficient headroom to bring about the urgent changes required by a modern NHS.

“Primary care commissioners must not be overshadowed by centralisation and a secondary care dominated health system, which has, time and again, failed to deliver better services for patients and tax payers,” says NHS Alliance chair Dr Michael Dixon. 

He adds: “If proposed changes to Government health reforms go ahead as announced last week, they are in real danger of neutering clinical commissioning. It would be tragic to see it join the rubbish dump of previous similar initiatives, such as Practice Based Commissioning, Primary Care Groups, Locality Commissioning and Fundholding.”

The Alliance has concerns about proposals for clinical networks (‘covering many more areas of specialist care, which will be given a stronger role in commissioning’) and senates to be ‘hosted’ by the NHS Commissioning Board. The Alliance believes there is a real danger that these plans, as they currently stand, could result in greater centralisation and secondary care dominance.

“We need to make sure this does not happen,” emphasises Dr Dixon. “All practices and GP commissioners need to be involved. Senates should be only advisory not authorising and we must ensure that the full voice of primary care commissioners is represented within them.”

Dr Dixon continues: “We also have concerns that Health and Wellbeing Boards, while not having a strict veto, will have a ‘clear right to refer plans back to the clinical commissioning group or NHS Commissioning Board’ if they are not in line with their own plans. We cannot have commissioning consortia being challenged with every controversial action because they are bound to be faced with a whole range of difficult decisions.

“The crucial next step for the NHS is that frontline clinicians should be thoroughly involved in planning local services and making sure that those services are used cost effectively. It’s difficult to see how they are going to be able to do this when they will be at the beck and call of the NHS Commissioning Board, Monitor, the clinical senates, the Health and Wellbeing Board, Uncle Tom Cobley and all.”

According to the NHS Alliance, Government and the Department of Health now need to reassure frontline primary care clinicians, especially GPs, that there is still a real intention to devolve decisions locally to frontline clinicians and their patients. ”Visible action to show that clinical commissioners really are in the driving seat of reform and that the future NHS will be driven ‘from the consulting room rather than Whitehall’ is now required,” says Dr Dixon. “The Government and department of Health will have to work very hard indeed to restore the confidence of leading GP commissioners, who have devoted so much time and energy in making their part of the NHS better, but now feel that true primary care empowerment and clinically-led commissioning could be compromised.”

 Notes:

1.   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

 

2.   For more information, please email pressoffice@nhsalliance.org or call 07772756674.