The Department of Health is considering giving hospital doctors a say in the authorisation of GP consortia, the NHS medical director has said.
Speaking last week at a conference hosted by Monitor and the Healthcare Financial Management Association, Sir Bruce said the clinical cabinets would be loosely based around the primary care trust clusters and could have statutory powers.
He said NHS chief executive Sir David Nicholson had intended to release the proposed structure of the commissioning board last week but had been delayed by the listening exercise.
Sir Bruce suggested the clinical cabinets would be a “coalition of the willing” between representatives from consortia and secondary care.
Discussing what sort of powers the cabinets would have, he said: “It needs to have a bit of an edge but not at the strategic health authority level. Clinical cabinets will be more of a forum.”
He added: “Will these clinical cabinets have a major role in… authorising consortia? All these cards are in the air. I don’t know where they will fall.”
He suggested the cabinets’ roles would include approving changes to pathways, overseeing the development of clinical networks and being the “go-to place” for health and wellbeing boards.
He also said the NHS Commissioning Board could have five departments “led by senior clinicians”, structured around the five “domains” of the outcomes framework.
These are preventing people from dying prematurely, end of life conditions, helping people recover from periods of ill health, ensuring people have a positive experience of care and treating people in a safe environment.
He also asked the conference: “How can we prevent financially driven unilateral bad behaviour? We’ve already seen that with some of the early consortia.”
His question was a reference to consortia threatening to pull activity away from providers.