HSJ understands that the Department of Health wanted to allow PCTs to set their own pay levels to attract GPs to join PECs, as the trusts seek to improve clinical engagement, but government lawyers realised at the last minute that it would require a change of law.
New guidance from the DoH, Fit for the Future, says only that more information on GP payment for time spent on PEC work will follow, after DoH lawyers established that it would require primary legislation to allow PCTs to set GPs' pay.
But despite the setback over pay, the NHS Alliance, which has campaigned for greater influence for PECs, welcomed the new guidance, published this week.
The guidance says PEC chairs should be included in meetings between strategic health authorities and PCTs, and instructs PCTs to 'prioritise development opportunities for PEC members'.
It echoes the results of the NHS Alliance consultation Fit to Lead, carried out for the DoH late last year. Dr Peter Reader, the NHS Alliance's author of Fit to Lead, said: 'For the first time, we are seeing advice to SHAs that they should include PEC chairs in their meetings with PCTs. The conventional practice has too often been to exclude clinicians.
'The department has also acknowledged the need for personal development in clinical leadership and for clinical leaders. That is a welcome step forward. We must now make sure the spirit of this document is implemented in practice.
'There have been positive words in the past but SHA and PCT senior managers who were less than enthusiastic were able to sideline PECs. That must not happen again,' he added.
Royal College of GPs chair Professor Mayur Lakhani said he was 'not convinced' the new strategy would improve clinical engagement in primary care decision-making. 'We had hoped to see more ambition in the new proposals,' he said. 'What was needed was something that would embolden GP leaders and allow them to fuel the clinical engine room of the new PCTs.
'Commissioning is the make-or-break policy for PCTs, and this is contingent on effective GP engagement. Progress in this area should be monitored closely and I would like to have seen proposals for clinical engagement 'metrics' so that achievement can be measured.'
Each SHA will hold regional meetings to discuss the implementation of Fit for the Future, starting in London on 3 May.