PharmacoEconomics & Outcomes News 624 - 19 Mar 2011

GP commissioners "faceformidable obstacles"

A report from the King’s Fund says that generalpractice (GP) commissioners "face formidable obstacles"if they are to effectively lead the reconfiguration ofcomplex services in the NHS.1

The report, prepared by Keith Palmer, chair of Bartsand London NHS Trust, gathered data from thereconfiguration of services across hospital sites in south-east London – a project driven by financial and qualityconcerns within that area. The aim was to examine thequality and cost of reconfiguration and to outline thewider lessons for the future reconfiguration of NHShospital services in England.

The report says market forces alone will not deliverthe changes that are needed. It says that "strongcommissioning of emergency and network servicesacross a large catchment area is necessary to bring aboutmajor improvements in patient outcomes". It points outthat the individual primary care trusts in south-eastLondon were too small to drive the changes. Thus,commissioning by even smaller GP consortium will beunlikely to achieve service improvements in major areassuch as cancer, cardiac, stroke and renal care. It saysthat the new NHS Commissioning Board needs to begiven both the statutory powers and capability to ensurethat these improvements can be achieved.

The report argues that the best way forward is to"support acquisitions of financially challenged trusts byhigh-performing foundations trusts". However, this "willremain a purely theoretical option unless theDepartment of Health/NHS provides funding to defraythe large one-off restructuring costs and agrees torefinance legacy debt", says the report.

Costs for GPs to work on consortiumsconsiderable

Meanwhile, the chair of the Royal College of GeneralPractitioners, Dr Clare Gerada, estimates that the costfor GPs to work on commissioning consortiums inEngland could be about £300 million.2

These costs will result from the estimated 3–5% ofGPs who are involved with the consortiums spendingtime away from their patients. "GPs are more expensivethan managers", says Dr Gerada. She also stressed howimportant it was that the public did not think that "GPswere trying to make cost savings".1. Palmer K. Reconfiguring hospital services: lessons from South East London.

Internet Document : [44 pages], 3 Feb 2011. Available from: URL: http://www.kingsfund.org.uk.

2. Wise J. RCGP chair says it will cost 300m pounds for GP time on consortiums.BMJ : [3 pages], 2 Mar 2011. Available from: URL: http://dx.doi.org/10.1136.bmj.d1396.

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PharmacoEconomics & Outcomes News 19 Mar 2011 No. 6241173-5503/10/0624-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved