It will be a “disaster” if primary care services are performance managed centrally, a senior GP has warned.

Under the government’s reform plans, the NHS Commissioning Board will be responsible for holding GP contracts in order to avoid conflicts of interest within commissioning consortia. Although consortia will be expected to play a part, the new board will also therefore have overall responsibility for performance management of poorly performing practices.

But Royal College of GPs commissioning champion Douglas Russell told HSJ’s General Practice Forum in London on Tuesday that local consortia would be best placed to hold practices to account.

A report on commissioning from the health committee this week also said reconstituted consortia should be in charge of commissioning general practice. This view is shared by the National Association for Primary Care but not by the British Medical Association’s GPs committee.

Dr Russell said tackling performance was better done locally. “The local intelligence, the up close and personal knowledge of what is going on, you need that if you are going to do something about [poor performance],” he said

Consortia should be responsible for primary care commissioning and should identify an independent clinician to perform this role. But he admitted it would be difficult to hold practices to account.