GP consortiums must learn from US experience, says expertBMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d3720 (Published 13 June 2011) Cite this as: BMJ 2011;342:d3720
- Nigel Hawkes
GP led commissioning in England could lead to financial crisis for many consortiums if US experience is ignored, an American expert advises.
Lawrence Casalino says in a report for the healthcare policy think tank the Nuffield Trust that, of 1500 doctor led networks and groups set up in the United States, only a 10th proved successful at managing the financial risks of commissioning.
Many failed, and some went bankrupt, for a mixture of reasons. These included too little focus on the management and infrastructure needed to handle the financial risk; a lack of clinical leadership; resentment among patients that family doctors were acting as gatekeepers to care; an inability to stand up to the tough negotiating stance adopted by hospitals and specialists; and shrinking budgets imposed by insurers.
The US networks, called independent practitioner associations (IPAs), are the closest international parallel to the …