A primary care trust has been criticised by the Cooperation and Competition Panel for giving GPs leading roles in a decision to close a rival primary care centre.
The CCP ruled Peterborough PCT had not appropriately managed conflicts of interest in a consultation which led to a decision to close the Alma Road Primary Care Centre, it was announced last week.
It is a “Darzi centre” GP practice with walk-in and urgent care services and is run by the firm 3Well Medical.
The CCP rejected several other complaints made by 3Well. The CCP said the summer 2011 consultation as a whole was not flawed and that closing the centre would not restrict choice.
However, it said procurement guidance had been breached because two Peterborough GPs acted as “lead GP commissioner” and “GP urgent care commissioner lead” for the work. The urgent care commissioner lead was also medical director of Cambridgeshire Community Services, a rival urgent care provider. The CCP said the GPs “were associated with providers that would be directly affected, and might gain” from the changes. The CCP is now consulting on potential “remedies” for the situation.
The PCT had told the CCP one of the reasons was the government requirement, introduced in July 2010, that such service changes “must have the support of the commissioning GPs”.
NHS Confederation Partners Network director David Worskett told HSJ the case demonstrated “a problem which is going to get worse” as GP-led clinical commissioning groups increasingly take over budgets.
The CCP is now consulting on potential “remedies” for the shortcomings in the consultation. It has suggested an independent group of clinicians could review the proposals.
NHS Peterborough and NHS Cambridgeshire chief executive Sushil Jathanna said it had previously asked for the National Clinical Advisory Team’s view, and indicated it could do again.
A statement from Dr Jathanna also said: “We welcome the report from the CCP and are pleased to note that the CCP have concluded that the PCT followed a process which met the CCP principles of transparency, choice and competition.
“We have reflected on the processes and feel that we managed potential conflicts of interest appropriately, but accept that the CCP has recommended we work further to engage independent clinicians outside the Peterborough area to provide further assurance… It is important to state that we do not believe that there has been any actual conflict of interest and that the clinicians we involved in answering questions from the public have not profited in any way from this process and no evidence was found to the contrary.”
Dr Jathanna also highlighted the issue of managing such conflicts when GP-led groups are leading commissioning. He said: “We would also like to work with the CCP and the Department of Health in looking at governance arrangements and would like the CCP to look at this in the context of future clinical commissioning.”
He said the PCT would resume its work on the reconfiguration, which has been suspended, when the CCP makes a final decision.