The move to fully functioning GP commissioning consortia is likely to be more gradual than the overnight process that the government originally planned, NHS chief executive, Sir David Nicholson, has indicated.
Under the government’s plans consortia are due to take over the commissioning of around £80bn of NHS care from April 2013.
However, Sir David, who is also the chief executive of the commissioning board, which will eventually oversee the consortia, told the Financial Times that consortia will have to be authorised before they can take over the money, and that many will be ready, implying that the timetable will be extended and that the planned overnight switch to GP commissioning will have to be rethought.
How consortia will be accredited will be based upon the results of pathfinder consortia who are piloting GP commissioning. In an interview with the Financial Times Sir David said that performance on finance, how patient demand is measured to ensure patients do not end up in hospital unnecessarily, and tackling underperformance in primary care would all be taken into account. He added that authorisation would be a process rather than a “pass/fail test”.
He said: “The vast majority of consortiums will make it, I think. But some of them will be authorised with conditions. So you will give some of them more responsibility than others, inevitably, I think, as you go through the process.”
Conditions could include ability to take financial decisions, or some services being run by the commissioning board until consortiums demonstrated the necessary competence.