Health Secretary Andrew Lansley has announced a fourth group of GPs ready to lead the way and modernise the NHS.
220 groups of GP practices across the country covering nearly 90% of the population have come forward so they can directly commission bespoke services focused on delivering the best outcomes for their patients. This means that 45.7 million people around the country will now receive personalised care from the clinician that knows them best.
The selected pathfinders represent GPs who have demonstrated readiness to start taking on commissioning responsibilities. The groups will work together to help manage local budgets and purchase services for patients directly with other NHS colleagues and local authorities.
In Barnet, for example, the NHS has worked together to set up a very successful local gynaecology service which is currently seeing 400 patients every month in a community setting. It has high levels of patient satisfaction, has led to a reduction in hospital visits and reduced costs.
In City & Hackney, GPs and hospital consultants at Homerton University Hospital have worked together to reduce new Outpatient Department referrals by 2.5% over the last year.
From the first, second and third wave of pathfinders, there are a number of further examples of innovative local commissioning:
- Barking & Dagenham Quality Care Consortium identified ophthalmology as an area where they could redesign services for the benefit of patients and bring care closer to home. Working together with consultants from their local acute trust and the primary care trust, they have developed a community based ophthalmology service which is expected to start later in the spring. This will allow GPs and optometrists to refer patients directly to the new service, reducing patient waiting times and avoidable hospital referrals.
- In Nottinghamshire, GPs have improved care for the 4,000 diabetics in their region. By providing specialist support in local clinics in GP practices, the service avoids diabetics having to be treated in hospital.
- In Redbridge, GPs send patients with skin problems to a local GP who specialises in them, meaning that patients can go to a local surgery, instead of having to travel further afield.
- In Reading, GPs have organised a new service for people with back pain where physios go and treat patients in their own home.
- In Richmond, GPs have identified a need for more responsive community services to avoid unnecessary acute admissions. Working together with their local community services provider they are providing intensive support to patients in their own homes and have jointly designed a rapid response community team to get back to patients within two hours of contact.
GP pathfinders will be supported by the National Clinical Commissioning Network, the National Leadership Council, and by national primary care bodies, such as the Royal College of GPs’ Centre for Commissioning.
Dear Mr Landsley
I am completely opposed to your HS reforms. Currently the NHS is receiving its highest levels of satisfaction. Why not build on this success instead of destroying and risking organisational reforms that may not work. I think you are just being ideological and unltimately want to privatise the NHS
Colin Ride
I welcomes the government’s delay in the Bill and its stated commitment to consult front line health staff, but on behalf of those staff I say the Bill is fundamentally flawed and should be abandoned.
Cherry Picking to Remain
The Bill is still flawed as it will still require all health services to be subject to compulsory competitive tendering. This will lead to cherry picking of profitable health services leading to destabilisation and possible closure of remaining NHS services. The policy is also hugely bureaucratic and expensive.
Wrong Change, Wrong Time
I also believe that the Bill is fundamentally flawed in seeking to place most commissioning of NHS services into the hands of GP consortia. GP’s don’t want to be commissioners, they want to be GP’s. They do want better design of services with other health staff so care is closer to home (see examples*). The Bill would damage the major moves to this already underway, the NHS and patients doesn’t need nor want another upheaval.
in our area the nhs is working well but with all the changes senior staff are leaving as their positions are becoming untenable and are being replaced by semi professional staff who cost less to employ.This is causeing patient concerns.We dont need any more change.Docters are clinitians not accountants.
I endorse what has already been said.
GPs are doctors- trained to care for patients. They are not health service managers.
The examples quoted of “pathfinder” GP s working together with hospital services to improve joined-up care shows that the last Conservative government’s Purchaser-Provider split is only now being brought back together in some places. Privatisation and giving more purchasing power to GPs will only split this up again with competition generating more divisions rahter than savings or improvements.
Finally, the fact the all these GP practices have signed up as consorita does not mean that they endorse the proposed changes. Just because most passengers and crew of the Titanic climbed into the lifeboats, it did not mean that they approved of the ship sinking.
I think many people misunderstand some of the specific details of these proposals. GP’s will not be commissioning in the technical sense of the word. Nor will they be managing finances. Commissioners and accountants will still be employed, they will just be working more closely with GP’s than they were previously. Under the current/former PCT system, thousands of commissioners and accountants were employed across the country. Realistically, this work is not going to be carried out by GP’s, as they have neither the time nor technical expertise to do it. Shropshire PCT has already started recruiting for finance professionals to work within the consortia.
Also, under the current/old system, GP’s are encouraged to be involved, and regular meetings between GP’s and PCT’s occur to get the input of GP’s into the commissioning of services. All these proposals do is make it far easier for GP’s to partake in this process. As front line health professionals with a first hand experience of community health issues, it is right and necessary for GP’s to inform the decisions of managers and accountants.