GPs Account for Under Half of CCG Board Members
GPs account for less than half of the available leadership roles in the emerging clinical commissioning groups (CCG) across England, igniting concerns that doctors are being pushed aside from the decision-making procedure on which services to offer patients.
According to an enquiry by Pulse magazine, replies from 100 different clinical commissioning groups exposed that only 645 of the 1,325 board positions were held by doctors (with five CCGs unable to confirm their board’s makeup), leading a number of people to query if the GP’s part in commissioning is being diluted.
In some areas GP representation on the boards was shockingly low, for example, Nottingham West with 20% and Bury with 21%. In contrast, in Medway, Sandwell and West Birmingham CCGs’ GPs held a minimum of 75% of the board positions.
Clinical lead and deputy chair of Nottingham West CCG, Guy Mansford, informed Pulse that Nottingham West practices were cutting the amount of GP board members from five to two in order to reduce costs and address possible issues of conflict of interest.
Yet, in a subsequent statement displayed on Pulse’s website Mansford also notes that the amount saved as a result has facilitated the creation of a Clinical Innovation group on which the remainder of the GPs sit.
“There they do what they do best, which is think up innovative clinical pathways together with our patient reps. These are then signed off by our small lean board which handles the conflicts of interest,” Mansford highlighted.
Bob Senior, head of medical services at RSM Tenon and chair of the Association of Independent Specialist Medical Accountants, commented that the £25 management allowance was a influence in the structure of several boards. “The economies of scale don’t work so smaller [CCGs] are having to use that money judiciously, which means you can’t have quite as big an involvement from GPs” he noted.
However, Dr George Rae, secretary of Newcastle and North Tyneside LMC, claimed that the balance had swayed too far. “If it is GP-led commissioning, the correct balance isn’t GPs in the minority. There are other people who have to have input, but we must not sell ourselves short,” he commented.
Speaking at an NHS Commissioning Board meeting last week, Dame Barbara Hakin, the government’s National Director for Commissioning, also allegedly added a positive viewpoint on things, claiming that the tendency to permit a larger number of non-GPs on CCG boards was permitting other groups to have a greater say in the commissioning of services.