Practices should not feel under pressure to make new working plans following the July white paper on health, Health Secretary Andrew Lansley has said in a letter to all GPs in England to clarify the proposals.
The letter, sent on Friday 24 September, could reassure GPs and practice managers after some commentators had urged doctors to move quickly soon after plans for GP-led commissioning consortia were laid out.
In July, the NHS Alliance suggested that GP commissioners should get their consortia up and running immediately. "Time is of the essence," warned Dr Michael Dixon, NHS Alliance Chairman. "We need to get this off the ground as quickly as possible."
However, Mr Lansley's letter suggests that GPs should merely anticipate the move to consortia and make appropriate plans. "At the moment, you will wish to consider what the appropriate organisational form which suits your own particular circumstances might be … the organisation and governance arrangements which will apply in due course will flow from this vision".
However, the letter also encourages GPs to establish an "interim approach" to commissioning whereby PCTs devolve decisions to groups of GPs and other clinicians. Mr Lansley stressed that this would not mean initial decisions are "set in stone for the longer-term", as doctors will be free to develop their plans over time.
The letter stated that no decision has been taken on the value of consortia's management allowance. Mr Lansley reiterates that the size of consortia will not be determined centrally.
The health secretary appeared to seek to reassure GPs who may be concerned over the amount of work required. "The proposed reforms are not about burdening you with paperwork, or involving you in the minutiae of the administration needed to support your commissioning decisions," he wrote, "but about giving you overall responsibility for the design of services which meet your patients' needs."
Dr Johnny Marshall, Chairman of the National Association of Primary Care, said: "The association is heartened by the encouragement given by Mr Lansley to practices, consortia, as well as to PCTs, to advance work on GP Commissioning, where they are currently minded to do so.
'I know many PBC groups and emerging consortia have been concerned about organisational arrangements. Mr Lansley's letter provides exactly the right advice at the right time and will be reassuring to our members and others."
What's your view? Are you any clearer over your GPs' plans for commissioning consortia? Your comments (terms and conditions apply):
"We would love to set up as a consortia of approx 120,000 in Newbury. The local PCT has indicated that it supports a larger vision and the proposal is to form a single GP-led commissioning consortium across West Berkshire. How are we supposed to work with that?" – Kamal Bahia, Newbury
"It appears from Mr Lansley's letter that GPs would be free to establish GP commissioning according to their patients' need. It may imply that smaller groups, say up to 10,000 patients, might be able to form a consortia collaborative" – Mr S Kumar, London
"Same old confusion and lack of clarity to allow GPs to be blamed if it all goes pear-shaped – or even if it does not! Just being spouted by someone different" – Name and address withheld