GPs could be forced to take on ex-PCT managers

This is despite the white paper highlighting the freedoms being granted to GP commissioners to decide the source of management support.

I really fear that people will move to the private sector

GPs might only be able to escape the obligation to take on PCT staff if they restricted the size of their consortia. However, this would cut across another freedom promised by the white paper. It says: “Practices will have flexibility within the new legislative framework to form consortia in ways that they think will secure the best healthcare and health outcomes for their patients and locality.”

Hempsons solicitors head of employment Jean Sapeta told HSJ it was likely that many consortia management roles would be similar enough to those in PCTs to require the application of the transfer of undertaking (protection of employment) Regulations (TUPE).

This means PCT employees would have to be transferred into consortia positions if the roles were similar to their roles at the PCT. Consortia would also need to match the terms and conditions given to the role under the PCT. Many GPs would find this “hard to swallow”, Ms Sapeta said.

Cabinet office guidance sets out the principle that, even where TUPE is not technically applicable, it should still be used in public sector staff transfers.

A Department of Health spokesman confirmed it would apply this “fair deal” to staff affected by the abolition of PCTs and strategic health authorities.

The ability of managers to transfer will depend partly on the size of the new consortia. If a new job covers a much smaller or larger area than a PCT role, transferrals are less likely.

However, some locality commissioning roles could closely match the areas covered by consortia.

Royal College of GPs chair Steve Field said he understood managers could be forced onto consortia but was more worried those with the most experience would “jump ship”.

He said: “I really fear that people will move to the private sector. The NHS cannot afford to lose high quality managers.”

PCT network director David Stout said he “imagined” TUPE would apply in a significant number of cases and called for clarity.  

He also warned against an overly prescriptive approach, saying: “If the experience GP commissioners get of the new system is a terribly top down process, that fails at the first hurdle.”