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‘Unwise’ for CCGs to define GP ‘core’ services

6 December 2012

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Clinical commissioning groups (CCGs) would be “unwise” to start playing a role in defining the ‘core’ services’ of a GP contract.

Dr Richard Vautrey, deputy chair of the British Medical Association’s (BMA) GP Committee (GPC), said while CCGs should have a role in determining GP enhanced services, it would be “inappropriate” for them to start “micromanaging” the GP contract by defining what is core.

“It would be unwise if CCGs started to [define GP core services] and it would be straying significantly away from their commissioning role and into the NHS Commissioning Board’s remit,” he said.

Dr Vautrey’s comments come in response to a speech made by Dame Barbara Hakin, managing director of commissioning development at the NHS Commissioning Board (NHS CB), at the NHS Alliance conference in Bournemouth last month (21 November 2012), in which she said she was “heartened” by the number of CCGs that are “taking it upon themselves” to identify a practice’s core services.

“I am hopeful CCGs will work with practices to define a basket of core general practice services and identify what is above and beyond as additional services while allocating funds where acceptable,” she said.

“This will happen better locally than if the Board tries to define core services on a national scale.”

She insisted CCGs involvement in GP contracts was not a devolvement of responsibility as the NHS CB “still retains overall responsibility”.

Dr Vautrey urged CCGs to focus on identifying and resourcing GP enhanced services and not to misinterpret Hakin’s “off the cuff” answer as an open door to examine the core contract.

“There is good reason to separate the contracting roles between CCGs and the NHS CB,” he said.

“It is important that both parties understand what their roles are and don’t stray into other areas.”

A spokesperson for the NHS CB sought to “clarify” Hakin’s comments around CCG involvement in the GP contract.
They said many CCGs are working on making “educated assumptions” on the likely content of the core GMC contract in a bid to identify additional services they wish to commission but are not individually designing GMS and PMS contracts.

“CCGs will be able to commission a wide range of community-based services that meet the health needs of local communities, including primary care services that go beyond the scope of the GP contract,” said the spokesperson.

“Many CCGs are already working to identify these services, and their efforts were applauded by Dame Barbara Hakin at the NHS Alliance conference.”