GPs must embrace NHS changes, says doctor

A MORPETH GP says it is vital that doctors engage with a programme of controversial NHS changes to ensure smooth transition for patients.

Dr Alistair Blair, who works at the Wellway surgery, is acting as interim leader of the Northumberland Commissioning Consortia until a formal board is appointed next month.

The group, which includes all doctors’ surgeries in the county bar one on the North Tyneside border, is working on Government plans for GPs to take control of local NHS budgets and commission services for patients.

The change will see consortia take over the role from primary care trusts (PCTs), which are set to be phased out from April 2013.

But the national proposals have attracted strong criticism from some healthcare workers and unions, who say the changes are happening too quickly, the upheaval is unnecessary and it will lead to greater commercial competition for the NHS from private companies.

However Dr Blair says whatever their views on the plans, doctors are agreed that they need to take part in the transition process.

“This is a national initiative and there will be change therefore it is important to engage with it so our patients can be best represented,” he said.

“There is a mix of views about the proposals. There are some who are very supportive and one or two are sceptical about the whole thing, but where there is agreement it is that if this is happening we are better to be engaged from a patients’ point of view than burying our heads in the sand.

“The primary care trusts are being wound up from April 2013 so our job is to make sure that there is something fit for purpose in their place.

“This is a two-year evolution rather than a revolution.”

The Northumberland group was announced as a ‘pathfinder’ by Health Secretary Andrew Lansley as one of 141 similar consortia of GPs across the country.

Doctors will work together to commission services such as hospital care, mental health units and community care like district nurses, but they will not be responsible for buying primary care provision, including GP and dentistry services, which will be done by independent boards.

Dr Blair says there will be no changes to doctor patient relationships and GPs will not be expected to take on accountancy roles.

“These will be clinically led commissioning consortia, but the finance and clerical work will be done by experts, not GPs,” he said.

“It is not a case of GPs suddenly running the budget. We hope to put a clinical emphasis on the commissioning, but we will not be running the whole show. It is about making sure that the clinical issues are at the forefront of the decisions made.

“We perceive it as a change from management led commissioning towards clinically led commissioning.”

He added: “Whoever is on the consortia board will obviously be spending more time running the organisation and less seeing patients, but they would still have to have that clinical contact. This will not change the GP role face to face with patients.”

The North East Strategic Health Authority is leading the transition in the region and will support the development of five consortia — Northumberland, GatNet, County Durham and Darlington, Newcastle Bridges and Langbaurgh.

NHS North East Director of Commissioning Development Richard Barker said: “We continue to see a real enthusiasm from GPs in the north east to work together and improve outcomes for patients by putting local people at the heart of their commissioning decisions.

“We now have five GP pathfinders in the north east and are working with many others who are keen to form partnerships and come together in consortia. We are wholly committed to supporting both GPs and primary care trusts during this important transition period and making sure GPs feel fully prepared to take on this important commissioning role.”

Pathfinders will also be supported by the National Clinical Commissioning Network and the National Leadership Council.

However, the Royal College of Nursing (RCN) has criticised the lack of accountability and nursing involvement in the process.

RCN Regional Director Glenn Turp said: “Nurses can provide vital clinical expertise and yet there is no statutory requirement for GP commissioners to include nursing representation on their management boards.

“It suggests that the value of nurse leadership is not being taken seriously.”

He added: “The Government has not put in place any transparency measures or accountability procedures to ensure that hundreds of millions of pounds of local health money is spent appropriately. For example, there is no requirement for GP commissioners to hold their board meetings in public.

“It is all very well saying that accountability for the establishment of these new bodies rests with the strategic health authority, but the reality is that the Government is shortly to abolish the SHAs. What happens to accountability after that time?”

Unison has also condemned the plans as part of criticism of the wider NHS reforms.

Unison Head of Health Karen Jennings said: “These changes are undemocratic, they were not in any party manifesto and no one has been given the chance to vote on them.

“The NHS is a service that many take for granted now, but will not be able to in the future. As more private companies pile in to grab their share of the £80billion in taxpayers’ money the NHS will change from a publicly run and accountable service into a conglomerate of competing private companies outbidding the NHS for patients.”