This site is intended for health professionals only

Practice investing


4 September 2013

Share this story:
GP practices can get funding from their clinical commissioning groups if they have a good business case in line with commissioning aims
It is not always true that “it does exactly what it says on the tin”. So is the case with ‘clinical commissioning’ which, from the perspective of  member practises of clinical commissioning groups (CCGs), would have been better titled ‘the reform of primary care provision’. 

GP practices can get funding from their clinical commissioning groups if they have a good business case in line with commissioning aims
It is not always true that “it does exactly what it says on the tin”. So is the case with ‘clinical commissioning’ which, from the perspective of  member practises of clinical commissioning groups (CCGs), would have been better titled ‘the reform of primary care provision’. 
As membership organisations, CCGs, rather than spending most of their time and energy on analysing and monitoring their contracts with secondary care, should be primarily ensuring the quality, capability and capacity of their member practices to extend care for the registered population out of hospital.  
Commissioning at scale in the reformed NHS was always about the clinical community behaving differently in their day-to-day interactions with patients and their personal accountability about the deployment of NHS resource utilisation. 
If this is understood and accepted, then CCGs can really get on with the business of reforming the experience, compassion and quality of NHS care while maintaining value for the public purse. Therefore CCGs need to give serious consideration to investing in their constituent practices to promote both innovative and extended service provision. 
Possibly the two most significant areas where CCGs could make this investment to reform care is in the management of long-term conditions (LTCs) and supporting the strain on urgent care provision in the NHS. 
We haven’t really begun to repatriate patients from hospital outpatient review for their LTC’s back into the community.  At best, hospitals discharge between 10-15 % of their total caseload from outpatient departments annually. Similarly, patients generally access services urgently when they are awake. Evidence shows that about three quarters of all urgent care presentations within the NHS are during the contractual hours of general practice. 
CCGs therefore should give consideration to investing both time, personnel and funding to support a skill mix which integrates community services, social care and the third sector within general practice to deliver against the need of a registered population. The should also consider resourcing different access arrangements both with opening hours and access to specific health or social care professionals within a practice. 
Our practice has been successful in securing some funding to demonstrate the way a general practice can significantly improve urgent care services. This however did rightly involve creating a business case, demonstrating the evidence for transformational change in general practice delivery, detailed costings, the metrics by which service change and value for money could be measured and a range of expected outcomes which would be transferable and sustainable within the CCG and beyond. This type of business planning is going to be important for general practice to develop and CCG should be supporting this. 
Transformational change within out NHS will be delivered by a focus on improving care out of hospital and the support of list-based practice is key to this reform.

Want news like this straight to your inbox?

Related news


Care staff
Managers expected to cover staff shortages caused by mandatory vaccines
Care home managers and service providers are expected to cover employee shortfalls caused by mandatory...
New RCGP president to lead from November
Professor Dame Clare Gerada will take over as the new president of the Royal College...