GPs are bowing down to pressure to sign constitutions allowing CCG leaders to measure practice management and performance, the Deputy Chairman of the BMA's GPC has claimed.
Dr Richard Vautrey told MiP the GPC has seen a number of draft CCG constitutions seeking to "dictate" to practices in a number of ways, including how they should prescribe medication.
He said the fear CCGs would replicate the same relationship seen between PCTs and practices has "become a reality".
While some have resisted signing such CCG constitutions, many other GPs have signed up "because they felt they had no other choice", Dr Vautrey told MiP.
"We have to be very careful to not recreate a top-down PCT approach, whereby CCGs impose change and practices," he said.
"While I'm sure CCGs are drafting these consitiutions with the best of intentions and in a bid to ensure every practice is engaged, it seems they just do not understand the boundaries and remit they must abide by.
"To continue pushing through these constitutions would undermine clinical leadership."
Dr Vautrey said such tensions have arisen thanks to the move away from CCGs being "clubs you can join", to having no choice in becoming part of them.
His comments follow guidance published by the BMA designed to educate both GPs and CCG leaders on what a constitution should and should not include.
"While the constitution should outline responsibilities of practices as members of the CCG, CCGs will not have responsibility for performance management of practices," says the document.
"The responsibilities outlined in the constitution should relate to the practice's role as a member of a commissioning group and should not stray into general practice contract management or dictate expectations relating to performance."
By Louise Naughton