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GPs are losing interest in CCG roles

GPs highly engaged in CCG work falls from 19% to 12% over past year

Adrian O'Dowd

Tuesday, 27 January 2015

GPs are losing interest in their CCGs, are getting less involved directly and those who are involved are struggling to meet the demands of the work, according to a new report from two health think tanks.

The report Risk or Reward? The changing role of CCGs in general practice from the Nuffield Trust and The King's Fund raises concerns about the future of CCGs, the doctor-led bodies established in April 2013 to plan and fund local health services.

CCGs are at risk of becoming unsustainable because of changes to the way primary care is commissioned, fading levels of engagement from GPs with a formal role in CCGs and cuts to CCG management budgets, says the report.

In the report, which is the second of a three-part study by the two organisations looking at the development of CCGs, the authors surveyed 279 GPs, interviewed 70 GP leaders and GP members of CCGs, reviewed board papers, and tracked six CCGs selected to represent those across England.

The research comes as some CCGs prepare to submit detailed plans later this week to NHS England on co-commissioning – the proposal for CCGs to commission GP and other primary care services in partnership with NHS England local area teams from April.

Although CCG leaders and GP members surveyed were positive about taking on an extended role in primary care, the researchers found the benefits of co-commissioning could be undermined by conflicts of interest within CCGs, tight resources and strained relationships within CCGs and with NHS England locally.

Almost half (47%) of CCG leaders surveyed said they did not feel they had enough time to fulfill their existing role in the CCG, and CCG leaders interviewed as part of the fieldwork questioned whether they had sufficient capacity to expand into primary care commissioning.

While most CCG leaders felt that conflicts of interest were being managed adequately, researchers highlighted examples of decisions where there was the potential for, or the perception of, a conflict having occurred.

The research also found that there had been a significant drop in the numbers of GPs who reported being highly engaged in the work of their CCG, from 19% of respondents in 2013 to 12% in 2014.

The researchers also highlighted how difficult it was for CCGs to retain GP leaders when they reached the end of their initial term of office.

The think tanks made several recommendations to help CCGs make the transition to co-commissioning and ensure CCG sustainability.

These included:

  • adequate funds to help CCGs involved in co-commissioning fulfil their new roles
  • a strategy to help recruit and retain GP leaders in commissioning
  • focused work to develop non-GP members of CCGs to mitigate against conflicts of interest

Holly Holder, fellow in health policy at the Nuffield Trust and one of the report’s authors, said: “Our research shows that the future of the clinical role in commissioning healthcare remains fragile.

“While CCG leaders overall are still highly engaged in their work, our fieldwork and survey revealed this is waning and there are some worrying signs emerging over strained resources – both time and money.”

Ruth Robertson, fellow in health policy at The King’s Fund said: “Our research shows that CCGs have the potential to play a really important role in driving improvement in the health service, but to do this they are going to need the right resources and support, along with the freedom and flexibility to develop local solutions.”

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