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Clinical commissioning groups don’t reflect our views, say GPs

But CCGs do influence GPs’ work – and they listen more than PCTs used to

Louise Prime

Tuesday, 01 April 2014

Fewer than half of GPs believe that clinical commissioning groups’ decisions reflect their views, the latest survey shows. However, GPs do say that CCGs are much more likely to listen to them than primary care trusts used to.

In January and February, the Nuffield Trust and The King’s Fund surveyed GPs from six CCGs, chosen to be representative of a wide range of different areas. They found that fewer than one in eight (12%) of GPs overall now feel ‘highly engaged’ with CCGs, a marked drop from nearly one in five (19%) last year. Almost three-quarters (71%) of GPs feel at least ‘somewhat engaged’, which is comparable with last year’s results.

But among GPs without a formal role with the CCG, the proportion who felt that decisions made by the CCG reflected the views of their membership plummeted to below than four in ten – and fewer than a third said they felt CCGs were owned by their members. Furthermore, most of the GPs who did have a formal CCG role felt they hadn’t enough support, time and training to properly carry out their roles.

Holly Holder, fellow in health policy at the Nuffield Trust said: “Concerns remain about CCGs’ ability to involve local GPs in their work … only a third of GPs without a formal role reported that the CCG felt like ‘their organisation’ and a similar proportion said CCG decisions simply didn’t [reflect] their views …

“NHS leaders should pause for thought at the fact that only a minority of CCG leaders told us they felt they had enough support, time and training to carry out the roles they have already been tasked with.”

Despite this, GPs were generally positive about how CCGs could change and improve general practice. More than half said their relations with other practices had already improved since becoming part of a CCG, as had the way in which they referred and prescribed; fewer said it had improved the overall quality of care that they provide.

Whereas very few (13%) of GPs said that before the reforms the primary care trusts would listen to them, 40% said they could influence the CCG’s work. And almost three-quarters (73%) of GPs said CCGs were ‘very’ or ‘quite’ influential over their own work – which is more influence than they credited to any other body, even NHS England.

Ruth Robertson, fellow in health policy at The King’s Fund, commented: “Without close engagement from at least a core group of GPs, this key benefit they have over their predecessor PCTs will be lost. We will be paying close attention to engagement trends over the next year, as the sustainability of this commissioning model is dependent upon maintaining GP interest and enthusiasm during the tough times ahead.”

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