GPs support the government’s plans for clinical commissioning but warn the “scale, pace and cost” of the reforms may not be justified, according to the Royal College of General Practitioners.

In its response to the Liberating the NHS white paper consultation, the college said its members had welcomed plans for their proposed increase in leadership and influence but also raised concerns.

It said: “Some of our members are not convinced that the scale of the changes proposed is justifiable, especially in the context of cost reductions.

“They are concerned that the proposed scale, pace and cost of change will prove disruptive; and that the proposed reforms may not achieve the stated aims because they will divert effort, costs and human resources into complex commissioning and local decision making.”

The college also said training for future GPs would need to be extended to five years to ensure they had the “ability to commission and manage resources, and facilitate patient choice”.

Additionally it said members were concerned about how the reforms in England would affect cross-border areas, with different training requirements in England and Wales, for example.

They were also worried that proposals giving patients a free choice of GP could be “damaging in terms of continuity of care, health inequalities and potentially, patient safety”, and could threaten the viability of rural practices.

However the RCGP said its members backed the white paper principle of “shared decision making” with patients.

The RCGP consulted its 42,000 members across the UK and internationally in drawing up its response.

RCGP chair Professor Steve Field said: “Our members – ‘jobbing’ GPs throughout the UK – can always be relied upon to act professionally and constructively, with the best interests of our patients at heart.

“We feel that this response is as comprehensive as possible and that it appropriately reflects and represents the views of RCGP members.”