First group of CCGs for commissioning GPs’ services is announced

BMJ 2015; 350 doi: (Published 20 February 2015) Cite this as: BMJ 2015;350:h975
  1. Adrian O’Dowd
  1. 1London

The first group of GP led clinical commissioning groups (CCGs) have been given new powers to take on commissioning of GP contracts and services in England.

Doctors’ leaders, however, have expressed some concerns about no resources being attached to the additional role and a perceived conflict of interest among the GPs involved.

On 18 February NHS England announced that it was approving the first set of CCGs to take on responsibility for commissioning most GP services in their area from April this year. In total, 64 CCGs across the country have applied for and been approved to take on greater delegated commissioning responsibility, and others may follow.

Taking on delegated responsibility from NHS England means that CCGs will commission general medical services, hold GP contracts, manage practices’ performance, and set up local incentive schemes. Delegated responsibility is one of three models offered to CCGs, along with joint commissioning with NHS England and greater involvement in commissioning. Decisions on the CCGs that will be approved for joint commissioning will be made in the next few weeks.

Amanda Doyle, co-chair of NHS England’s primary care co-commissioning programme oversight group, said, “This is a journey to enable local commissioning arrangements that can deliver the kind of integrated care, in and out of hospital, that we all want to see. Giving GP led clinical commissioning groups more influence over the wider NHS budget will enable a shift in investment from acute to primary and community services and [will] enable money to follow the patient.”

Richard Vautrey, deputy chair of the BMA’s GP committee, told The BMJ that genuine concerns about this development for CCGs had to be faced.

“It’s inevitable that this was going to happen,” said Vautrey. “There is clearly a direction of travel of moving some of the responsibilities from area teams back to CCGs in line with the responsibilities that primary care trusts had before.

“One of the big concerns is that no resources are being passed alongside these responsibilities to CCGs. There are also big concerns around the perception of conflicts of interest, which will have to be very carefully handled for those CCGs concerned.”

Louise Irvine, a member of the executive of the National Health Action Party, a political party formed by doctors, nurses, paramedics, and patients to defend and improve the NHS, was also sceptical. She told The BMJ, “I am concerned about conflict of interest. I don’t see why GPs can commission other GPs. The whole fundamental structure of the NHS, with CCGs commissioning and the purchaser/provider split, is really wrong. This seems to me to be a fudge, and neither one thing nor another. I can see all sorts of problems with it.”


Cite this as: BMJ 2015;350:h975

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