The NHS commissioning board will be able to delegate its role of ensuring GP practices improve on quality of care and financial management to consortia themselves, the Department of Health has said.

The Department of Health has today published a consultation paper – Liberating the NHS: commissioning for patients – with more detail on proposals on the future of commissioning set out in the white paper.

The document says the government wants the performance of consortia as commissioners to “be closely bound” with driving up the quality of medical care and use of NHS resources provided by its constituent practices.

As a result, it proposes the NHS commissioning board should have the power, where it judges it appropriate, to ask consortia to take on “promoting quality improvement, reviewing and benchmarking practice performance and ensuring clinical governance requirements are met”.

The paper says: “This would enable consortia to apply peer review and challenge in the first instance to areas where there appear to be unwarranted variations in practice or outcomes, for instance in relation to prescribing or the systems in place to support management of long-term conditions.”

However it states that the board would retain overall responsibility for commissioning and contractual decisions.

It adds: “The role of GP consortia in helping promote quality and review practice performance will also help ensure that action to ensure good financial management sits alongside and complements GPs’ clinical responsibilities to patients and their role in supporting patient choice.

“This means promoting innovations that improve both quality and productivity, whilst challenging any behaviours that are inappropriate both for good clinical care and for efficient use of NHS resources.”

The consultation also confirms that the government wants to renegotiate the quality and outcomes framework – the points and payment element of the general medical services contract – so that it better reflects outcomes rather than processes.

It states: “We want the QOF to focus more on the health outcomes that are achieved for patients and to provide incentives for continuous improvements in quality of care.”

The paper also says the government wants to move over time towards a “single contractual and funding model for GP practices”, which promotes fairness, choice quality and removes “unnecessary barriers to new providers”.

Practices are currently run under one of three contracts – the national general medical services (GMS) contract, locally negotiated personal medical services (PMS) contracts or alternative provider medical services contracts for the independent sector.

Responses to the document must be submitted by 11 October.