GP Consortia
The White Paper ‘Equity and excellence: Liberating the NHS’ set out the Government’s proposal for the responsibility for commissioning NHS services to be moved from PCTs to newly formed GP consortia. It is intended that commissioning by GP consortia will mean that the redesign of patient pathways and local services is always clinically-led and based on more effective dialogue and partnership with hospital specialists. The aim is that this will bring together the responsibility for clinical decisions with the financial consequences of these decisions. The specific role of GP commissioning consortia will be:
- To commission all NHS services except for primary care services (including services that GPs themselves provide), and specialised national and regional services.
- To hold contracts with providers.
- For every GP practice to be a member of a consortium. Practices will have flexibility to form consortia in ways that they think will secure the best health outcomes for their patients and locality.
- To have a sufficient geographic focus to be able to take responsibility for agreeing and monitoring contracts for locality-based services (such as urgent care services), to have responsibility for commissioning services for people who are not registered with a GP practice, and to commission services jointly with local authorities.
- To manage the combined commissioning budgets of their member GP practices, and use these resources to improve healthcare and health outcomes.
- To decide what commissioning activities they undertake for themselves and for what activities they may choose to buy in support from external organisations, including local authorities, private and voluntary sector bodies.
- To work in partnership with local authorities, for instance in relation to health and adult social care, early years services, public health, safeguarding, and the wellbeing of local populations.
- To engage patients and the public in their neighbourhoods in the commissioning process. Through its local infrastructure, HealthWatch will provide evidence about local communities and their needs and aspirations.
Specific services that will be the responsibility of GP Consortia to commission are:
- Community health services (except where part of the public health service)
- Maternity services
- Elective hospital care
- Urgent and emergency care including A&E, ambulance and out-of-hours services
- Older people’s healthcare services
- Healthcare services for children, including those with complex healthcare needs (except for those specialised services commissioned by the NHS CB)
- Rehabilitation services
- Wheelchair services
- Healthcare services for people with mental health conditions
- Healthcare services for people with learning disabilities
- Continuing healthcare
Consortia may agree to commission some health improvement services jointly with local authorities. This could include, for example, obesity, smoking cessation and drug/alcohol services. In some cases, the NHS CB may be asked to commission a service on behalf of Public Health England and may in turn arrange for consortia to commission the service on its behalf. These arrangements and the detail of the respective responsibilities of NHS and public health commissioners are subject to the outcome of the ‘Healthy Lives, Healthy People: Our strategy for public health in England’ consultation (which ended on 8 March 2011).
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