Plans for the development of GP consortia to commission health services at a local level have been outlined by the Government.
The proposed structure for commissioning and local control of health services is described in two new consultation documents, Commissioning for patients and Local democratic legitimacy in health.
The documents expand on the White Paper Equity and excellence: Liberating the NHS and invite comment from patients and other stakeholders.
Commentators in the private sector and the NHS have pointed to the major opportunities in service management and provision that this new structure may open up for independent healthcare providers.
Andrew Lansley, Secretary of State for Health, said: “Power has to be devolved to local people so that decisions about their health are made by them, or by people that best understand their needs. Everyone should have their say in these consultations so we can get on with building strong local partnerships and improve people’s health.”
Local democratic legitimacy in health describes the Government’s plans to give new Local Directors of Public Health control over local health improvement funds, which they will use to improve public health, support patient choice and promote effective commissioning. This, it is hoped, will enable healthcare to be more effectively integrated with social care and other services.
The long-term aim is to build a national Public Health Service to support local decisions with evidence and evaluation. Patients will be represented by local ‘HealthWatch’ groups that will voice their health and social care needs and impact on local service planning.
Commissioning for Patients sets out detailed proposals to put GP consortia in charge of commissioning local health services, with the support of the NHS Commissioning Board. The document invites feedback on:
• How GP consortia and the NHS Commissioning Board can involve patients in improving health services.
• How GP consortia can work with secondary care, community partners and other health and social care professionals to design services.
• How the NHS Commissioning Board and GP consortia can work together to make effective and efficient commissioning decisions.
• How the NHS Commissioning Board can support GP consortia to ensure they improve health outcomes within the financial constraints set.
Dr Hamish Meldrum, Chairman of BMA Council, commented on the plans for GP commissioning: “There are still many questions that need answering. The proposals contain both opportunities and threats and we will be actively engaging with the consultation process to explore this in great detail and to ensure our members’ views are taken on board.”
Given the anticipated workload and financial pressures on GP consortia, it has been widely predicted that independent healthcare providers will soon play a large role in managing and providing NHS healthcare. According to Tribal Healthcare’s Business Development Director, Kingsley Manning, the new structure “could amount to the denationalisation of healthcare services in England”, with major opportunities arising for the private sector.
Health Minister Earl Howe stated: “We want consortia to have the freedom to arrange themselves how they wish and get support from whom they choose. All consortia will need to be well managed and we are not asking doctors to become managers.”
The consultations will run until 11 October. NHS Chief Executive Sir David Nicholson has sent a letter to NHS organisations requiring the transfer of commissioning powers to be carried out as soon as possible.