How much should GPs be paid for working on clinical commissioning groups? There is no easy answer, but failing to address this issue will spell trouble for the new organisations.

Over three-quarters of CCGs are now authorised and the rest will follow in March ahead of the 1 April go-live date.

‘Pay too little and they will not be able to attract talent, pay too much and they will be challenged by the board and media’

A significant minority have been authorised despite concerns over the quality of their leadership, while others have been wished “Godspeed” largely on the basis of the experience and local clinical connections of their governing bodies.

Given the bewildering to-do list facing CCGs and the relatively short time that any new NHS organisation is given to make an impact, the groups will only succeed if they can rely on high-quality and consistent leadership. That may be undermined if CCGs fail to develop effective remuneration strategies.

Transparency essential

Pay too little and they will not be able to attract the talent they need, pay too much and they will be challenged by the board and media on value for money, as well as running the risk of burning through their management allowance.

Some possible solutions are explored in a thorough review by Peter Smith. But whatever solution CCGs find works best, they should avoid the temptation to obfuscate the sums being paid.

GPs, who unlike hospital directors are unused to finding their earnings public knowledge, may find this uncomfortable but lack of transparency would undermine CCG credibility just as it is being established.