Fears are growing that GPs will lack the necessary skills to become effective commissioners when they take control of the NHS budget in April 2013.
An investigation by GP Business has found poor take-up among clinicians of what little training available for new GP-led clinical commissioning groups (CCGs).
Department of Health advisory body, Primary Care Commissioning (PCC), has attracted more than 7,600 attendees to its scheme since August 2011. However, just 750 were from CCGs and it is unclear how many of these were former PCT staff.
Julian Patterson, a spokesperson for the PCC, said there has been a mixed response from CCGs to the training due to an "overestimation" of CCG appetite for some areas of support.
He said that facilitation training, which is designed to ensure productive meetings, has proved popular with CCGs, while negotiation skills management has been popular among PCT staff.
"This is down to CCGs still not being sure whether they are actually going to be in the driving seat when it comes to buying services," he said.
Patterson said CCGs currently "across the board...undoubtedly, a 100 per cent, do not have the skills needed to become professional buyers and procurers of NHS services."
He warned many CCGs clinicians are leaving it late to upgrade their skill set.
Another, now withdrawn CCG 'coaching' programme run by the NHS Institute last year attracted the attention of a quarter of CCG 'teams'.
While nine CCG teams have completed their coaching programme, 49 teams are still undergoing their training leaving an estimated 180 CCGs that failed to take advantage of the offer.
A modular training scheme provided by the NHS Alliance under its Clinical Commissioning Academy has also had poor take up among CCGs. While it has recorded more than 1,200 NHS workers attending one or more of its training events during the past five years, a spokesperson could confirm only two CCGs have committed to work through all 19 modules of the training course.
GP Business reported in March that the Royal College of GPs' (RCGP) commissioning support programme had "died a death" as it chose to oppose the government's health reforms.
Russell Vine, chair of the Practice Management Network and one of the RCGP's Clinical Commissioning Champions made the comments.
Shedding light on the poor take up Dr Phil Moore, chair of Kingston CCG covering 185,000 patients, said training for GPs is being kept local due to time constraints. "To be honest, anyone trying to organise any kind of CCG meetings is finding it difficult to fill them because people are up to their necks in it working towards the CCG authorisation process," he said.
A local leadership programme has had a "pretty good turnout" according to Dr Moore, with around 12 out of the 130 GPs associated with Kingston CCG taking part.
Dr Simon Hambling, Chair of Cambridgeshire and Peterborough CCG covering 850,000 patients, said: "The SHA has allocated £10,000 to every CCG in the area for developing its leadership but for a big CCG like ours, that money is peanuts. "Training [for CCG members] is absolutely necessary - there is a huge amount of work that needs to be done."
Moves are being made to tackle the CCG training gap although details have yet to emerge. The NHS Commissioning Board is planning to launch a CCG development tool and Commissioning Academy, and the NHS Leadership Academy will aim to support the next generation of NHS leaders through its assessment centres.
A joint initiative between the NHS Alliance, National Association of Primary Care and NHS Confederation has also provided the first CCG membership representative body – NHS Clinical Commissioners.