Sharing responsibility may be uncomfortable work for medics
One of the purported strengths of the new commissioning system is that clinicians working together will be able to achieve more because of their common background.
The potential misunderstandings between clinician and non-clinician will be removed and better solutions will be reached more rapidly. It is believed this collegiate approach will be to the fore not only within clinical commissioning groups, but also between CCGs and medical leads at providers or those sitting on clinical senates.
It is also, as HSJ’s cover feature makes clear, important that a close relationship is formed between CCGs and the medical leads of the NHS Commissioning Board’s local area teams.
Cynics may argue that without the mitigating role of NHS managers, the potential for rows between those who can all claim “professional” insight will be even greater. But let us assume, as is likely to be the case, that medics in these roles will have the inclination and ability to work together.
They will then have to determine who takes the lead, on what decisions and in what circumstances. Medics have inherent respect for the opinions of fellow doctors, but properly integrated healthcare does not conform to neat professional boundaries. Hammering out a shared vision will be uncomfortable for many.
The quality “surveillance groups” being created to monitor the new system may be where many of these tensions surface. Issues identified in these forums will need a doorstep to be delivered to. That responsibility may be shared – between a commissioner and provider, for example – but any pain resulting from attempts to solve the problem is often likely to affect one party more than another.
The biggest challenge for individual medics taking a greater involvement in the planning and organisation of NHS services may not be to grasp the intricacies of commissioning or service redesign, but to acknowledge they will be held responsible for decisions in which their voice is one of many – and not always the loudest.
Have your say
You must sign in to make a comment.
Share
Readers' comments (5)
phil kenmore | 25-Jun-2012 1:12 pm
And when the real agenda is de-commissioning (to prevent simply fiddling at the edges) - thats when the real tensions may emerge between clinicians involved in these processes. Who is going to want to be seen to be 'on point' when the news is publicly only seen as 'bad'?
Unsuitable or offensive?
Patrick Newman | 25-Jun-2012 2:21 pm
The biggest challenge in my humble opinion is simply the time 'medics' will have to run CCG's and the time they will need to acquire expertise they do not have to be effective in commissioning and in transforming the NHS (Not to mention the 20bn 'savings').
Unsuitable or offensive?
Anonymous | 26-Jun-2012 12:25 pm
Patrick - hence the plethora of committees like senates and OSCs and HealthWatch - all the "help" being offered to blur the blame. But my 80 year old mum said she'd rather have an honest debate about what we can afford, not lots of complicated documents or meetings. This needs to move into the public domain not be brushed under the carpet but no politician seems willing to pick up the mantle. Shame, because if done properly across all parties, we might actually have a chance of dealing with the "perfect storm" round the corner.
Unsuitable or offensive?
Sunita Berry | 26-Jun-2012 5:25 pm
Perfect storm? What perfect storm? Healthcare costs will continue to rise inexorably across the world because death is the only certainty and humans are not particularly sanguine about leaving this world. Given our need to clutch on to our lives and the propensity by medicine to continue to sell snake oil but only in slightly different guises, and that the snake oil has to be visibly sold in expensive surgical or other interventional procedures, then there is not a hope that the public will accept the need for this austerity. More over, Mr Lansley wants to create at 'trillion dollar' healthcare industry that is so vaunted by those who he aspires to and from where he learns his lessons - the US and you can see where the 'growth plan' for England lies. Add to this and the demand for ever narrow regulation/specialism and you have the perfect spending storm. It is a good time to retrain and become a doctor.
Unsuitable or offensive?
Anonymous | 26-Jun-2012 5:25 pm
Can someone please put me out of my misery and excuse my ignorance? I that this was about Clinical Commissioning not just GP Commissioning. How exactly does one get onto a CCG. I have never seen any expressions of interest. And for that matter how does one get onto one of the Clinical Senates and exactly what will the composition be?
Unsuitable or offensive?