'Direct management' of under-par consortia an option, says Nicholson

In his first interview since his appointment as chief executive of the National Commissioning Board, Sir David told HSJ he would consider “direct management” of consortia that failed to reach the appropriate standard by April 2013.

Discussing the options, he said: “It is possible there might be a third way of putting in direct management to make it happen.”

He stressed that this would be “very, very rare”, saying: “The most obvious thing would be to identify the practices and put them in with other consortia, to re-allocate them.

“Or we could put different kinds of management in to manage it on their behalf until they are in place. We are not going to have a lot of these organisations.”

The power would mean the NCB would refuse to authorise consortia that could not prove they met the required standard by April 2013 and split their constituent practices between others.

It is not clear if the “direct management” would be imposed centrally the NCB or by a residual primary care trust cluster – Sir David told a meeting of chief executives last month that if clusters were a success they could remain and support commissioning.

Sir David stressed there were more than two years before the consortia were due to start and that the authorisation mechanism was being worked on with the pathfinder consortia now.

GP consortia are due to get shadow budget allocations in April 2012, before being fully authorised a year later.