New BMA chief issues warning over CCG restructures

Richard Vautrey was elected chair of the British Medical Association GP committee this month.

Dr Vautrey called for some clinical commissioning group staff to be transferred into emerging large scale GP providers so they can continue to support GPs.

In an interview with HSJ he also warned that, while government would “tick its box” by on the face of it creating extended GP opening across the country, it was not actually improving access because the service offer was being “diluted”.

Speaking to HSJ about the rapid move to share senior management across CCGs, mergers, and development of new “accountable care” structures, he pointed out that many CCG staff also effectively provide administrative and managerial support for general practice.

Dr Vautrey – a GP in Leeds, where three CCGs are planning to merge – warned: “All of that resource [for support] is embedded in CCGs and the worst thing that could happen is that as CCGs start to merge together and become bigger again… that they take all of that [support] resource including their workforce, into the commissioning [role] of the CCG.

“What we need is for that commissioning bit to become much smaller, but the resource in terms of funding and people who support the management and the back office for general practice… to devolve to new forms of provider structures, whether it be federations or super practices.”

He said: “However, it is structured, the resource that has been embedded into CCGs needs to come to them [providers] because otherwise they will struggle, because you can’t run an org without that administrative support and management support.”

Meanwhile, Dr Vautrey raised concerns about the reality of NHS England’s target for all areas of England to meet its requirement for extended GP opening hours by April 2019.

The new GPC chair said: “It has been completely diluted, patients are still being told they’re going to get an appointment in the evening and on the weekend, when the reality is the money [for access] is half [what] was originally in place. So many areas in the prime minister’s challenge fund [initiative] got significantly more than they will end up with [at the end]…

“That means there will be fewer GP appointments, fewer appointments overall… fewer patients will be able to get those appointments that would have otherwise have been the case.

“That means the government would be able to tick its box and say, ‘We’ve achieved it [extended access]’, but actually what they’ve achieved and delivered is much less than what was planned.”

Dr Vautrey told HSJ that the £6 per patient promised by NHS England to CCGs to help implement extended GP hours should go in to “core” general practice funding, to be used in all hours.