Are the GPs in south-west London the most proactive in the capital?

You could make a fair case that they are, as the past month has seen them publicly rebuke their cluster chief executive, order two trusts to redo their homework on foundation trust applications and appear to spill the beans on a common-knowledge-but-still-not-official hospital reconfiguration.

The Kingston GP consortium has written to its primary care trust cluster chief executive setting out its commissioning complaints.

The consortium tried to pull rank on a number of topics including unsuccessfully demanding it was paid its £2 a head for commissioning costs early.

When HSJ reported this online, Charles Alessi, one of the lead GPs at the Kingston consortium, responded: “There is no conflict. It is an attestation of the maturity of our relationship that we are having this debate in public.”

Next door in Richmond and Twickenham, the GPs in the clinical cabinet meeting rejected South West London and St George’s Mental Health Trust and St George’s Healthcare Trust’s foundation bids.

They cited “insufficient clinical engagement from GPs to date”.

This is not a binding decision but will not help the provider duo as they work their way up to the Monitor application.

The same body let slip that an independent FT bid by nearby West Middlesex University Hospital Trust was now “not possible” - more than the trust itself has been willing to confirm in public.

As Dr Alessi said in his statement to HSJ: “This is the new world of clinical commissioning, a world which I would suggest is more transparent than the one that it has superseded.”