BMA votes against primary care co-commissioning

At the British Medical Association’s annual conference of local medical committees, delegates voted overwhelmingly in favour of a motion that “views with alarm” proposals for CCGs to be made co-commissioners of GP contracts.

The motion, proposed by Nottinghamshire Local Medical Committee, said the move would “fatally damage relations between CCGs and their constituents” and would “undermine the credibility of CCGs” and lead to “unacceptable” conflicts of interests.

The motion “insists that GP core contracts should not be held by CCGs”.

NHS England chief executive Simon Stevens this month confirmed plans to give some clinical commissioning groups the ability to co-commission primary care with NHS England.

CCGs have been invited to “describe the additional powers and responsibilities” they would like.

Nottinghamshire LMC vice chair Aneel Bilkhu said passing the motion would give the BMA’s GPs committee a mandate to “bring these reasonable and justified concerns more forcibly to the attention of ministers”.  

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Speaking in favour of the motion, Mitch Garsin, a member of Hillingdon CCG, told the conference that co-commissioning would be the “ultimate poisoned chalice”.

He said GPs excluded from discussions would mean that decisions on primary care would be taken by the “rump” of CCGs.

He added the move may allow “darker elements in the CCG leadership” to “harass… patient centred colleagues out of existence”.

Passing on more work to CCGs that are “already overstretched” would be a “disaster”, Lewisham GP Simon Parton warned the conference.

Some delegates expressed reservations about the motion. Somerset GP Barry Moyse pointed out that NHS England area teams, who currently commission primary care, are “remote, understaffed and lack knowledge”.

He added that CCGs are “colleagues who know what makes practices work” and “there may be advantages to be found” if they played a commissioning  role in primary care. 

Marek Jarzembowski, a member of Merton, Sutton and Wandsworth LMC, warned that GPs would be “vulnerable to a rigidity of position” if they did not explore possible options.

NHS Clinical Commissioners, the body representing CCGs, has warned that not involving CCGs in commissioning primary care could put patients at risk.

Earlier in the conference, GPC chair Chaand Nagpaul said the committee’s finding have shown that only one in five CCG have set aside an additional £5 a head for general practice, as outlined in NHS England’s latest planning guidance.