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NHS reforms ‘unlikely’ to achieve integration


8 November 2011

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Plans to replace PCTs with clinical commissioning groups (CCGs) are “unworkable” without a “huge” investment in commercial skills training, it is claimed.

A survey of 400 GPs shows the majority worry (85%) they do not have the skills necessary to handle their new commissioning roles and 90% have “real concerns” about their legal liabilities as members of a CCG.

Almost a third of respondents also believe the government’s target date of April 2013 for when CCGs will take control from their PCT is “unachievable”.


Plans to replace PCTs with clinical commissioning groups (CCGs) are “unworkable” without a “huge” investment in commercial skills training, it is claimed.

A survey of 400 GPs shows the majority worry (85%) they do not have the skills necessary to handle their new commissioning roles and 90% have “real concerns” about their legal liabilities as members of a CCG.

Almost a third of respondents also believe the government’s target date of April 2013 for when CCGs will take control from their PCT is “unachievable”.

Worryingly, 82% of GPs also feel they are ‘unlikely’ to achieve a key element of the planned NHS reforms in providing effective integration of a patient’s medical needs.

“It is clear that GPs have fundamental concerns about how CCGs will operate at a grass roots level,” said Andrew Lentin, Partner at Kurt Salmon.

“Fears about the financial management of CCGs together with the delivery of integrated services to patients, at this time demonstrate a serious mismatch between Government expectations and the GP community who will bear the responsibility for implementing the reforms.”

Nearly three-quarters of GPs (72%) admitted they have no experience in areas like data management, costing clinical services, negotiating with providers, procurement law, and contract and financial management.

Furthermore, some 50% of GPs have yet to formally create a CCG, and of those which had, almost three-quarters either ‘don’t know’ or ‘doubt’ their CCG leaders could successfully control commissioning budgets.

The survey was commissioned by management consultancy Kurt Salmon and law firm DMH Stallard LLP.

Do you think there is a ‘mismatch’ between the government’s expectations and GP capabilities?

Your comments (terms and conditions apply):

“No. GPs could run the whole NHS better than the present managers. The real problem is the unrealistic notions of the politicians and the reluctance to face up to the financial constraints on the NHS we are currently trying to deliver a much more universal service than any other country with far less money. The politicians and the public need to get real fast.” – Peter Gregory, Staffordshire

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