RCGP chair backs co-commissioning of general practice

In an HSJ interview, Maureen Baker said a “partnership” of CCGs and NHS England area teams would be best able to determine the priorities of each area’s population and use local knowledge to ensure services were tailored to its needs.

“We absolutely have to get there,” she said.

“I am hopeful that co-commissioning will allow appropriate investment, particularly in those areas that have been really starved of funding.”

However, specific details as to how the arrangement would work, including which body would hold the contracts for general practice, would need to be negotiated by the two parties, she said.

Dr Baker’s stance differs from that of the British Medical Association which argues that commissioning such services under the GP contract would pose a conflict of interest.

However, the association does support GPs being involved in the commissioning of other areas of primary care.

There have been increased calls for CCGs to become involved in the commissioning of general practice.

In December last year NHS Clinical Commissioners wrote to NHS England chair Sir Malcolm Grant arguing that primary care responsibility should “sit with CCGs”.

The letter, shared with HSJ, stated: “We would urge you to support such a change and ensure that CCGs are given both the responsibility and the resources they need.”

Dr Baker also admitted there was “an issue with relative dissatisfaction in terms of access as far as patients were concerned” with “some patients in some practices… waiting too long to get appointments”.

However, she said there was “no elasticity” for extending opening hours without further funding.

“The concept of working eight to eight, seven days a week is more difficult to put in place in the general practice context because that then means extending your opening and staffing requirements by the order of 60-75 per cent. Hospitals are already open. Hospitals already have staff in.”

She said the creation of weekend services could mean staff were diverted from midweek work. But by “pulling people out of those regular services to put on extra services for longer hours or at weekends… you might then have greater availability for some citizens at the expense of others”.

This could “inadvertently destabilise” care in routine hours.

“We certainly can’t do it without more resources,” she added.