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Reforms ‘unlikely’ to achieve integration

7 November 2011

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GPs have “fundamental concerns” about how clinical commissioning groups (CCGs) will operate and most doubt integration of services will increase under the NHS reforms in England, according to a survey of 400 family doctors.

Most (85%) respondents worry they do not have the skills necessary to handle their new commissioning roles and 90% have “real concerns” about their legal liabilities as members of a CCG.

Almost a third of respondents also believe the government’s target date of April 2013 for when CCGs will take control from their PCT is “unachievable”.

The survey also found that 82% of GP respondents feel they are “unlikely” to achieve a key element of the planned NHS reforms in providing effective integration of a patient’s medical needs.

“It is clear that GPs have fundamental concerns about how CCGs will operate at a grass-roots level,” said Andrew Lentin, Partner at management consultancy firm Kurt Salmon, which commissioned the survey with law firm DMH Stallard LLP.

“Fears about the financial management of CCGs together with the delivery of integrated services to patients demonstrate a serious mismatch between government expectations and the GP community who will bear the responsibility for implementing the reforms.”

Nearly three-quarters of GPs (72%) admitted they have no experience in areas like data management, costing clinical services, negotiating with providers, procurement law, and contract and financial management.

Furthermore, some 50% of GPs said they have yet to formally create a CCG, and of those which had, almost three-quarters either “don’t know” or “doubt” their CCG leaders could successfully control commissioning budgets.

Do you think there is a “mismatch” between the government’s expectations and GP capabilities? Your comments (terms and conditions apply):

“Nigel has hit the nail on the head – GPs will have to delegate the work to their Practice Managers and others. Will GPs “retain control and set the vision”?  No chance!” – John Woolgrove, Kent

“No, I don’t. The trick is to devolve and subcontract work to others but retain control and set the vision. Practice managers have the skills to set up suitable support networks and even run Commissioning Support Units as colleagues have started to demonstrate” – Nigel Grinstead, Surrey