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NHS CB proposes new LES commissioning arrangements

15 August 2012

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The NHS Commissioning Board (NH S CB) has given its “strongest hint yet” that Locally Enhanced Services (LES) will be opened up to alternative providers post April 2013.

Published by the NHS CB last month (July), the ‘Enhanced services commissioning’ fact sheet confirmed while the Board will retain the ability to commission LESs through the GP contract, “it is unlikely to use it”.

It is expected then that LES funds will be devolved to CCGs and Local Authorities so they can commission services based on local needs and decisions.

“CCGs will be free to commission a wide range of community-based services funded from their overall budgets and they will commission these services through the NHS standard contract,” said the NHS CB fact sheet.

“CCGs will need to decide whether such services can be provided by a number of providers or only GPs. If they deem a service can be delivered by a number of potential providers… CCGs will either undertake competitive procurements or allow patients to choose a provider through the Any Qualified Provider route.”

Dr Michelle Drage, Chief Executive of the Londonwide LMCs, said a GPs marginal income potential is becoming “increasingly important” as it is “unlikely” GPs are going to see a significant increase in their practice income for “a few years yet”.

As such, Dr Drage said it is “very important” GPs retain LES funds and is concerned by the NHS CB’s latest guidance on the area.

“The NHS CB’s fact sheet published last month gives the strongest indication yet that LES is to be opened up to all providers,” she said.

“That represents a big risk to general practice as their marginal income is only going to get more important.”

However, Dr Laurence Buckman, Chair of the British Medical Association’s GP Committee, said he is not as worried by the potential new LES contracting arrangements and would be “surprised” if GPs found themselves with a smaller “slice” of locally directed services.

“The income from LES is so marginal, I’m not terrified about the changes but it is more about the principle of the matter,” he said.

“What we need to do is redefine what LES is and GP contracting talks are ongoing.”