Managers must encourage doctors to show that they can lead commissioning within PCTs and as practice-based commissioners, Dr Michael Dixon, Chair of the NHS Alliance, said last week.
In an address to the Nottingham Medico Chirurgical Society last Wednesday (4 February 2009), Dr Dixon (pictured) said: "Doctors must regain their passion, their commissioning zeal and the altruism of the 'commissioning days', and managers must regain that confidence, excitement and trust, which typified those early days of commissioning managers working with clinicians, and which allowed them to progress so fast and so effectively without a rule book."
Dr Dixon paid homage to Nottingham as the birthplace of Locality Commissioning Groups and today's practice-based commissioning (PBC) collectives.
"The Nottingham Non-Fundholding Commissioning Group was a great and early example of doctors leading in commissioning," he said. "In just a few years, 112 Locality Commissioning Groups had been developed and were being led by GPs all over the country.
"The irony is that we have had PBC for almost an equal amount of time but in too many places clinicians don't think that they are leading or making a difference."
Dr Dixon claimed that a reason for this is that PBC, which is strongly supported by the Department of Health, represents an "official model", unlike Locality Commissioning under the previous government.
"It [PBC] should be something that GPs would grasp as a new means of getting the best services and health for their patients and PCTs would embrace as a means of becoming efficient and properly grounded commissioners," he said.
"Yet PBC has only developed very slowly, with effective PBC and fully supportive PCTs still being in the minority."
Dr Dixon said managers should support, enable and embrace doctors, and should themselves act as "co-leaders in commissioning at every level".
"We must break down the tribal boundaries between different clinicians, between clinicians and managers, and between PCTs and practices," he said.