Intended for healthcare professionals


Key players for new GP-led commissioning are already leaving jobs

BMJ 2010; 341 doi: (Published 04 November 2010) Cite this as: BMJ 2010;341:c6272
  1. Adrian O’Dowd
  1. 1London

Expert managers in primary care trusts who could provide invaluable help to the new GP-led commissioning consortiums are already accepting redundancy, MPs have been told.

Doctors’ leaders giving evidence to the parliamentary health select committee on 2 November warned that the government should ensure there was a managed transition to the new NHS arrangements in which GP consortiums will control most of the NHS budget.

The worry was that expert managers were already leaving and might have to be re-employed by GP consortiums at a much higher cost from private sector companies.

MPs on the committee quizzed doctor representatives as part of their inquiry into how the government intends to implement changes to commissioning in the NHS through policies in the health White Paper.

Richard Vautrey, deputy chair of the BMA’s GP committee, giving evidence, said the BMA had serious concerns that senior primary care trust (PCT) managers were leaving their jobs and taking redundancy.

“One of the things that has often been misunderstood about this process is the idea that GPs are going to be running everything, doing everything, and managing everything,” said Dr Vautrey.

“There will be a very small number of GPs directly involved in management and leadership, but the bulk of the work will be done by expert lay managers and we hope the very people who are involved in the NHS now will be retained.

“What we don’t want to do is for the best managers to leave and go to large multinational firms only then to have to hire them back at an inflated rate of pay and to add on their redundancy payments as well.

“We’ve already got examples where whole departments of people have accepted redundancy terms and will be leaving very early on. We need to have a managed transition.”

MPs asked how the witnesses viewed the double challenge being faced by the NHS of making an expected £15bn-£20bn (€17.3bn-€23bn; $24bn-$32bn) worth of efficiency savings by 2014 while getting a radically different new GP led commissioning system up and running.

The witnesses said that by engaging the clinical community more actively in the commissioning process, the Department of Health was enhancing its chances of delivering the efficiency gain that it needed.

Dr Vautrey said: “One of the things we have welcomed as part of this white paper proposal is the greater clinical engagement the government wants to see.

“GPs and other health professionals want to get more involved, in partnership with their consultant colleagues in secondary care and public health doctors, to try to redesign care pathways, make them more responsive, to bring services closer to where people live.

“By doing so, that will hopefully achieve some of those savings and enable us to reinvest resources in better care pathways.”

Professor Steve Field, chairman of the Royal College of General Practitioners, also giving evidence, said: “What we have to offer as clinicians is about evidence based practice and looking with patients and the public at what sort of services are needed locally.

“We need to keep people out of hospital and we need to reconfigure some services. By clinicians leading, working across primary and secondary care, we can get more radical change than we’ve had over the past few years.”

The inquiry continues.


Cite this as: BMJ 2010;341:c6272

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