CCGs shouldn’t lose sleep over a practice’s engagement in the reforms as long as it is performing well, a senior commissioning leader has said.
Dame Barbara Hakin, National Director of Commissioning Development at the NHS Commissioning Board (NHS CB) told GP Business that if a practice is providing great services, it is “unlikely” to be an “unreasonable draw” on a CCG’s resources.
“I think that by far and away the most important thing for practices in the reforms is that they provide good primary care,” she said.
“As long as it does that it won't have a higher than average emergency admission rate nor will its prescribing be way out of kilter with everyone else.”
Hakin said CCGs are right to feel “disappointed” at a practice’s lack of involvement in the new commissioning arrangements, but said the organisations “mustn’t lose sleep” over it.
“If I was within a CCG and I had a practice that was providing absolutely brilliant primary care but they really desperately didn't want to get involved in the reforms, I would be disappointed and I would continue to encourage them to engage with the CCG because obviously they have got a great deal to offer everybody else but I wouldn't lose sleep over it,” she said.
She said CCGs and the NHS CB do have a joint agenda in chasing out poor practice and poor provision but claimed the clear line of separation with the board holding the GP contracts means any contractual problems or negotiations will “absolutely sit with the NHS CB”.
Dr Richard Vautrey, Deputy Chair of the British Medical Association’s GP Committee, said Hakin’s comments were “consistent” with the NHS CB’s line on practice performance management.
“The NHS CB has proposed almost an earned autonomy around those practices that are clearly delivering on their contract and services to their patients, allowing them to just get on with the job in hand as their first and foremost duty,” he said.
“If the practice is performing well, then the CCG really shouldn’t be placing inappropriate burdens on them.
Dr Vautrey said the key to practice engagement in CCGs is in creating a culture of support and encouragement.
“As soon as CCGs start forcing engagement, then that will backfire,” he warned.
DH advisor and President of the National Association of Primary Care (NAPC), Dr James Kingsland said Hakin’s words shouldn’t be interpreted as allowing practices to remain detached and remote from their CCG so long as they are deemed a “safe” general practice.
“Practices can be a little remote from the day-to-day operational workings of the organisation of the CCG but they are intimately involved every day and in every consultation in the programme of clinical commissioning,” he said.
“Practices shouldn’t be under the impression they can just turn up to a CCG meeting once in a while and give advice about what is happening with their patients because that would be wrong.
“Every clinician in every practice in every consultation needs to fit with the behavioural change required by the reforms.”