STRUCTURE: An independent sector provider of GP services is developing a commissioning consortium of non-neighbouring practices covering more than 40,000 registered patients.

Intrahealth is proposing to form a consortium from its 10 practices across the North East of England. The company is based in County Durham, where it developed from a long established GP practice. It now owns practices nationwide.

Intrahealth’s consortium proposal says it could later expand to other practices operated by the company and to “other likeminded practices”.

The proposal has been approved as an emerging consortium by County Durham and Darlington primary care trusts. However, Intrahealth has not applied to the Department of Health to secure pathfinder status for the consortium.

The plans state: “This proposal… challenges the notion of working in geographical 
clusters and opts for a model based on working with like-minded practices (having a similar or identical opinion, disposition).

“Intrahealth’s commissioning vision is to bring the care of our patients closer to home; we want our clinicians to have ownership and it to be local ownership with clinical decisions made closer to the patient.”

A document submitted to NHS North East says that in the short term the emerging consortium will use PCTs’ support functions such as contracting, finance and human resources. In the future it says it will “explore the option of absorbing these [functions] into our current structure or aligning PCT staff into these posts”.

The document adds: “Intrahealth will continue to work with other consortia in the area as we have done for many years. [This will] enable a sharing of best practice, redesign of care pathways and the negotiating with [foundation trusts].”

However, the company may come up against policy barriers to creating consortia made up of practices which are not all neighbouring.

The Department of Health has suggested it may be difficult for them to meet some authorisation requirements, for example commissioning for a non-registered population and emergency services.

Intrahealth co-director Glenn Carroll told HSJ: “Practically and administratively we are confident these problems can 
be resolved, but if it is a policy decision [to discourage such consortia] that makes it more difficult.”