Private sector role in NHS commissioning opposed
pharmafile | November 23, 2011 | News story | Medical Communications, Sales and Marketing | BMA, CCGs, NHS, PCT clusters
Private firms could be allowed to support clinical commissioning groups, the new NHS budget holders in England.
New draft guidance from the Department of Health: ‘Developing commissioning support: towards service excellence’, makes a number of recommendations about how clinical commissioning groups (CCGs) should function from 2013.
The government says CCGs will need support in a number of technical areas as they begin to take on health service budgets.
This support is based on non-clinical aspects of commissioning such as back office systems.
Currently, primary care trust (PCT) clusters are forming commissioning support units, but from 2016 would be encouraged to form social enterprises and partner with the private and voluntary sector.
The government said that a “strong and vibrant market will be critical” to help commissioning groups, and will allow commercial companies – as well as local authorities and voluntary organisations – to carry out these functions.
But the British Medical Association says these proposals would ‘position commissioning support in a full-scale market’, and introduce commercially-focused criteria to determine who is eligible to provide this support.
It says CCGs would be left with little choice but to use these large, commercial organisations to provide commissioning support services, as neither the voluntary sector nor local authorities would have the same resources as private firms.
This support would include back-office functions such as payroll and IT services, as well as equipping CCGs with the complex and sensitive population data that inform commissioning decisions, they said.
The BMA believes these issues raise ‘significant concerns’ and would lead to an imbalance of power between clinical commissioners and large, commercial providers of support.
It added that this would also undermine the government’s proposals for genuine clinician-led and locally focused commissioning.
PCTs should be the bedrock of CCGs
The BMA said that would rather see the current PCT system remain in place as the primary support system for emerging CCGs.
This is because PCTs have been managing the commissioning in the NHS for over five years and have invaluable experience to pass on to the new commissioning groups.
Dr Laurence Buckman, chairman of the BMA’s GP committee, said: “This latest guidance gives the commercial sector an in-built advantage and appears to be yet another worrying step towards an NHS focused on commercial priorities.
“The skills and experience of staff in current PCT clusters will be invaluable as they support the development of CCGs.
“To provide continuity at a time of huge financial pressure and structural overhaul, current PCT clusters should be supported to become viable commissioning support organisations and should not be forced into an unfair competitive process with large, commercial organisations.
“We are seeking an urgent meeting with government to urge them to reconsider these proposals,” he said.
The government said that further guidance will be released later this year and this draft paper will go towards building the best framework for commissioning support.
Ben Adams
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