GP commissioning fraught with risk, says NHS Confederation

11 Oct 10
GPs will struggle to get to grips with their new commissioning powers if NHS management costs are slashed by 45%, health bosses are warning.

By Vivienne Russell

12 October 2010

GPs will struggle to get to grips with their new commissioning powers if NHS management costs are slashed by 45%, health bosses are warning.

The NHS Confederation’s response to the government’s health white paper, published today, warns that the planned reforms are fraught with ‘significant risks’ and ‘worrying uncertainties’.

Chief among these is the devolution of commissioning to GP consortiums. ‘Commissioning health services is a complex task and GPs will need to quickly develop the capacity and capability to do this effectively,’ the confederation says.

‘Our members have major concerns that this will not be possible with 45% management cost reductions over the next few years.’

A related concern is the loss of skills and experience from primary care trusts as they are disbanded. The confederation is calling for urgent action to ensure good staff are retained and organisational memory preserved.

Nigel Edwards, acting chief executive of the NHS Confederation, said: ‘These reforms mean radical change, requiring a major shift in culture and the way the NHS does business, as well as a shake-u p of institutions.

‘It is imperative that the government does everything possible to address what is a significant list of uncertainties about how the new system will work. The fact of the matter is that the government is planning to build a very big new machine – at great pace – but no one can quite be sure what will happen when it is switched on.’

Other concerns contained in the confederation’s submission include accountability arrangements for GP consortiums and whether the commissioning system will be flexible enough to adjust to changes in demand.

The health chiefs also criticise the proposals for failing to make the most of the potential of GP consortiums to reduce health inequalities. They suggest that consortiums could make a big difference in these areas if they were given powers to performance manage primary care and make decisions on how to achieve the best value for money.

But there is support for giving local government a bigger role in public health and mental health.

‘We support giving local authorities the responsibility to facilitate joint working on health and wellbeing, with statutory powers to underpin this, because this would encourage them to fulfil their public health functions,’ the confederation’s submission states.

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