Issue - meetings

A report from East Sussex CCGs on future plans to commission GP practices.

11.1     This item was introduced by Amanda Philpott, Chief Officer, Hastings & Rother CCG.

11.2     Ms Philpott told the committee that NHS England (NHSE) was charged with commissioning primary healthcare services by the Health & Social Care Act (2012). However, in 2014 an option was introduced allowing CCGs to be delegated the responsibility for commissioning local GP services.

11.3     CCGs polled their members asking whether they wanted to take on these responsibilities. Members of HWLH CCG and EHS CCG opted to take on GP commissioning at the first opportunity. However, members of HR CCG voted to delay taking on additional commissioning responsibilities for one year. Members across all CCGs expressed a range of views, notably around the degree of risk involved in taking on GP commissioning. There are particular difficulties associated with the recruitment and retention of GPs in the Hastings area and this may have influenced thinking. The Local Medical Council was involved in this process and advised its members to delay for a year until more details of how localised GP commissioning will work in practice emerge.

11.4     In the longer term it seems likely that there will be further delegations of commissioning to CCGs, potentially including other primary care services and aspects of specialist commissioning.

11.5     Whilst there are risks to early adopters in taking on responsibility for the recruitment and retention of the local GP workforce, there are also risks inherent in not being in the first wave of GP commissioners. These are hard to quantify, but will consist mainly of reduced opportunities to take advantage of local knowledge and working relationships. However, the risk to Hastings & Rother should be mitigated by its very close working relationship with Eastbourne, Hailsham & Seaford CCG.

11.6     As local commissioning of GPs develops, GPs can expect to see better funding flows and simplified payment mechanisms for Practices, particularly for additional ‘locally commissioned’ services. However, in the very short term the focus will be on ensuring a smooth hand-over of responsibilities.

11.7     There is a potential conflict of interests involved in having CCG GPs commission GP services. To avoid this, all CCG commissioning decisions relating to GP services will be made by bodies with a majority of non-GP members.

11.8     In response to a question on the risks associated with GP retention, Ms Philpott told members that this was a major concern. 90% of NHS ‘contacts’ are made in primary care, but primary care services only receive 7.5% of the NHS budget ( a reduction from 10% a few years ago). East Sussex Better Together aims to increase the proportion of funding for primary care. There will also be an increased focus on GP training and recruitment, and greater emphasis on evolving the role of GPs: using them more effectively as a core part of multi-disciplinary teams.  In addition, the federation of GP practices will be encouraged where practices wish it.

11.9     RESOLVED – that the report be noted.