Pathfinder commissioning consortia are prioritising service integration but are overly focused on governance issues, according to a report shared exclusively with HSJ.

Analysis by policy and communications consultancy MHP Health Mandate of 156 of the 220 pathfinders shows that integration with social care was identified by 40 per cent as a priority.

A further 38 per cent named integrating care pathways and 25 per cent cited community service improvements. Urgent care was named by 15 per cent.

MHP said it was encouraging that many consortia were focusing on integrated service improvement, which was also likely to be a sign of joint working.

However, there were signs that some pathfinders were too focused on governance. Thirty-one per cent cited an aspect of governance as a priority. For 12 the only priority named was about governance.

The report said this was “concerning” and consortia should be “encouraged” by the Department of Health “to identify priorities which directly relate to the quality of care commissioned”.

This could be achieved by asking consortia to publish commissioning plans as quickly as possible, and encouraging them to develop “detailed identified priorities, enabling an assessment to be made of their success”.

Few pathfinders identified specific clinical areas as priorities, but of those that did, mental health was the most common, chosen by 8 per cent.

Five per cent named chronic obstructive pulmonary disease. The others named were musculoskeletal conditions, dermatology and diabetes.

The MHP report pointed out these named conditions were mainly managed in primary care, and featured in the quality and outcomes framework.

The report also said the DH should publish more detail about the priorities and measures consortia will be judged on. For example it could “set out in clinical outcomes strategies the measures which commissioners may wish to use”, and “signpost nationally comparable data”.

The report said that to prevent consortia spending too much time on governance, pathfinders’ work on the issue should be “collated and shared, so as to avoid duplication of effort”.

MHP Health Mandate managing director Mike Birtwistle said: “The early focus of pathfinders on integrating services offers encouragement to those who have argued GP led commissioning will lead to more joined up care.

“As GP commissioning develops, consortia should be encouraged to develop more detailed identified priorities – this will be essential for measuring progress and holding them to account.”