GPs 'denied freedom to make NHS reforms work'

GP consultation GPs are due to take charge of the NHS budget in 2013

GPs planning to take charge of the NHS budget in England claim they are being denied the freedom to make a difference to patients by "bullying" managers.

GP-led consortia will take charge of buying and planning care in April 2013.

The Clinical Commissioning Coalition, set up to represent the groups, said doctors felt they were being blocked and coerced by local health chiefs.

The NHS Confederation, which represents managers, suggested there was probably fault on both sides.

The consortia are meant to be working with local health chiefs in the run-up to the handover.

The coalition said it had been told by about 40 clinical commissioning groups - the official term for the GP-led consortia - that local managers had been bullying them.

'Stuck in the past'

Examples cited included groups being told to merge with others because they are considered to be too small and being given so little involvement with spending money that all they had power over was "paper clips".

The coalition said that the groups were being threatened with having their applications to "go live" in two years time blocked, which would mean the managers retained control of the budget.

What is happening with the reforms?

  • The bill underpinning the overhaul is still working its way through parliament; it is currently in the House of Lords
  • However, on the ground preparations are well under way to allow doctors to take charge of the budget by April 2013
  • More than 250 GP-led clinical commissioning groups have been established, covering well over 90% of England
  • They are in the process of getting shadow budgets, with the most advanced heavily involved with decision-making by managers working for primary care trust clusters
  • If the GP-led groups are not ready to take charge in two years' time, they will remain under the umbrella of the clusters

This is despite the government having consistently refused to set a lower or upper limit for the size of the groups, believing patients would be better served by letting them develop naturally.

Mike Dixon, one of the founding members of the Clinical Commissioning Coalition, said too many managers from PCT clusters were "stuck in the past".

"It is bullying and coercion and if we are not careful GP leaders will get disgruntled and walk away, and GP practices will not want to be part of it.

"All of what we wanted to achieve will be lost."

David Stout, of the NHS Confederation, said: "There will always be tensions and frustrations during periods of transition. In some cases PCT clusters will be reluctant to change, but in others they may be doing it for good reason.

"But the problem now is that it is starting to undermine confidence. We need to have adult conversations about this and make sure we get it right."

The Department of Health said managers should support doctors "not dictate how they operate" during the transition period.

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