GP buying 'will lead to fragmented service', says NHS trust CPO

14 July 2010

14 July 2010 | Angeline Albert

The head of procurement at an NHS trust has spoken out against the UK government’s plan to allow GPs to take on a crucial purchasing role.

Equity and excellence: Liberating the NHS, published on Monday, gives details of how the purchasing of healthcare will devolve from Whitehall to GPs, who will be responsible for an annual budget of £80 billion.

Consortia of GP practices will commission most NHS services for their patients, the white paper policy document said, and manage the combined commissioning budgets of their member GP practices. GP consortia are expected to hold contracts with care providers from 2013.

Currently, NHS primary care trusts (PCTs) manage GP services and commission care from hospitals but these will be abolished by 2014. PCTs are managed by Strategic Health Authorities and, ultimately, the Department of Health (DH).

One interim head of procurement at an NHS trust, who asked not to be named, told SM GPs would be put in the position PCT commissioners were in two years ago, when the DH’s World Class Commissioning team found the procurement of medical care needed a lot of development.

“This development of PCT commissioners’ procurement skills has been going on for two years and progress has been made. We may lose this good work with GPs having to be trained up in a raft of skills.

“Personally I think the decision [to make GPs responsible for medical care procurement] will lead to a fragmented service. A better route is to reduce the number of PCTs because they were starting to work collaboratively to commission and this could continue. How will it work if the procurement is fragmented into 500 different GP groups?”

Writing for the SM blog, consultant Peter Smith, who is a former CIPS president, said of PCT commissioning: “There was at least a sensible degree of demand aggregation in that structure. A total of 500 GP consortia in the proposed new system; that’s an awful lot of procurement events to go wrong.”

The white paper is the start of a consultation process. The DH will publish consultation documents on more detailed proposals.

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