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Plans for acute doctors on CCGs are unworkable

BMA warns CCG membership rules must be changed

Adrian O'Dowd

Tuesday, 21 August 2012

The government’s plans to include hospital doctors on clinical commissioning groups (CCGs) may not work and could exclude these doctors under present rules, according to the BMA.

The BMA has written a letter to health minister Lord Howe pointing out a basic problem with the regulations as they stand.

It may be necessary for the government to change the current stipulation that the secondary care clinicians on CCG boards must not be employed by providers from which the CCGs commission services.

The government said the rules, laid in Parliament in June, were intended to avoid conflicts of interest.

However, in their letter to Lord Howe, several BMA branch of practice committee leaders argue that this rule will prevent the effective local interface between primary and secondary care that was supposed to happen in CCGs.

The letter says: “The regulations prevent CCGs from benefiting from local expertise and formalising valuable relationships with secondary care colleagues.

They may also cause practical problems by making it difficult for the CCGs to recruit secondary care physicians to these positions.

“For example, there would be little incentive for medical directors elsewhere to release doctors for this work if it would not benefit their local area.”

The BMA argued strongly for the inclusion of secondary care clinicians on CCG boards during the parliamentary passage of the Health and Social Care Bill.

The letter, signed by BMA GPs committee chair Dr Laurence Buckman, BMA consultants committee joint deputy chair Dr Tom Kane, BMA staff, associate specialists and specialty doctors committee chair Dr Radhakrishna Shanbhag, and BMA public health medicine committee co-chair Dr Keith Reid, welcomes hints that the regulations could be relaxed.

NHS Commissioning Board chief executive and NHS chief executive Sir David Nicholson recently told Pulse magazine that there might be a need to take stock of the regulations if not enough consultants were recruited to CCG boards.

The BMA letter adds: “It is necessary for the NHS Commissioning Board to assess how CCGs are fulfilling the requirements of the regulations as they enter the authorisation process.

“Longer term, we feel that the board should commit to regularly review the impact of the geographical restriction on secondary care appointments in order to ensure that [it] does not limit the value of the secondary care presence on the CCG board.”

Pulse reported in July that only 7% of CCGs had appointed a consultant to their boards at that point, something that the BMA believed could be an early indication that the geographical restriction was acting as a disincentive for secondary care clinicians to apply for these roles.

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