The latest groups of GPs to take on commissioning responsibilities have been announced by Health Secretary Andrew Lansley. There are now 177 GP commissioning consortia covering two thirds of the country and 35 million people.
The selected pathfinders represent GPs who have demonstrated readiness to start taking on commissioning responsibilities and putting in place health services that achieve better health outcomes for their patients.
As a big step towards delivering the plans set out in the Health and Social Care Bill, the groups will work together to help manage local budgets and purchase services for patients directly with other NHS colleagues and local authorities.
Where emerging consortia have been formed, patients are already benefiting from local commissioning and healthcare services tailored to their needs.
For example, the Barking and Dagenham Quality Care Consortium identified ophthalmology as an area where they could redesign services for the benefit of patients and to bring care closer to home. Working together with consultants from their local acute trust and the primary care trust, they are developing a community-based ophthalmology service. This will allow GPs and optometrists to refer patients directly to the new service, reducing patient waiting times and avoidable hospital referrals.
In Richmond, GPs have identified a need for more responsive community services to avoid unnecessary acute admissions. Working together with their local community services provider, they are providing intensive support to patients in their own homes and have jointly designed a rapid response community team to get back to patients within two hours of contact.
From the first and second wave of pathfinders, there are a number of further examples of innovative local commissioning:
- In Bexley, GPs have put in place a new service that cuts the waiting time to obtain a diagnosis for coronary heart disease from up to nine months to as little as three weeks. The service uses a clinic in Harley Street to provide cutting edge scans, which are cheaper and safer than alternative diagnostic treatments.
- In Nottinghamshire, GPs have improved care for the 4,000 diabetics in their region. By providing specialist support in local clinics in GP practices, the service avoids diabetics having to be treated in hospital.
- In Redbridge, GPs send patients with skin problems to a local GP who specialises in them, meaning that patients can go to a local surgery, instead of having to travel further afield.
- In Reading, GPs have organised a new service for people with back pain where physiotherapists treat patients in their own home.
- In Somerset, GPs have organised oxygen therapy for people with breathing difficulties in their own homes which helps keep patients healthy and out of hospital.
- In Croydon, GPs have organised diagnostic services – such as ultrasound – in their local GP practices. This means that patients are seen quicker, nearer to their homes, and can avoid travelling to hospital.
Health Secretary Andrew Lansley said: ‘This is a truly bottom-up response, as demonstrated by the varying shape and size of the GP pathfinder groups. The speed of uptake is also highly encouraging. It demonstrates significant will on the part of GPs and nurses to get on with designing and purchasing NHS services, so that outcomes can improve for patients.’
GP pathfinders will be supported by the National Clinical Commissioning Network, the National Leadership Council, and by national primary care bodies, such as the Royal College of GPs’ Centre for Commissioning.