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GPs threaten to quit commissioning to concentrate on patients GPs threaten to quit commissioning to concentrate on patients
(4 months later)
GPs may have to give up working with the new NHS organisations that control £65bn of treatment budgets, to help their surgeries cope with the sharply rising workloads, medical leaders are warning.GPs may have to give up working with the new NHS organisations that control £65bn of treatment budgets, to help their surgeries cope with the sharply rising workloads, medical leaders are warning.
A few GPs have already pulled out of involvement with their local clinical commissioning groups (CCGs) because they could not spend enough time with patients while also helping run the groups. The growing demand for GP services is also making others consider withdrawing, even though CCGs are meant to be GP-led.A few GPs have already pulled out of involvement with their local clinical commissioning groups (CCGs) because they could not spend enough time with patients while also helping run the groups. The growing demand for GP services is also making others consider withdrawing, even though CCGs are meant to be GP-led.
Dr Clare Gerada, chair of the Royal College of GPs, said the difficulty of reconciling patient care with new managerial duties in their local CCGs meant it was "inevitable" some GPs would pull out of the CCGs.Dr Clare Gerada, chair of the Royal College of GPs, said the difficulty of reconciling patient care with new managerial duties in their local CCGs meant it was "inevitable" some GPs would pull out of the CCGs.
The 211 CCGs are the key new NHS organisations that, as a result of the coalition's NHS shakeup last month, replaced primary care trusts as the bodies to commission and pay for treatment for patients across England.The 211 CCGs are the key new NHS organisations that, as a result of the coalition's NHS shakeup last month, replaced primary care trusts as the bodies to commission and pay for treatment for patients across England.
"Sadly, for some GPs being involved with CCGs is taking up considerable amounts of their time. If you have a workforce crisis and if you have a workload that's not getting easier, it's inevitable that we must be in the consulting room trying to address that rather than in CCG board meetings outside consulting rooms, doing what could be done by managers. This is already happening to some extent", said Gerada."Sadly, for some GPs being involved with CCGs is taking up considerable amounts of their time. If you have a workforce crisis and if you have a workload that's not getting easier, it's inevitable that we must be in the consulting room trying to address that rather than in CCG board meetings outside consulting rooms, doing what could be done by managers. This is already happening to some extent", said Gerada.
"I find what many CCGs are doing immensely useful. But when push comes to shove, if GPs have to choose between seeing patients and involvement with a CCG, our first duty as clinicians is to our patients.""I find what many CCGs are doing immensely useful. But when push comes to shove, if GPs have to choose between seeing patients and involvement with a CCG, our first duty as clinicians is to our patients."
Dr Kailash Chand, the British Medical Association's deputy chair and a former GP who was awarded an OBE for his services to the NHS, said some GPs could not perform both roles adequately.Dr Kailash Chand, the British Medical Association's deputy chair and a former GP who was awarded an OBE for his services to the NHS, said some GPs could not perform both roles adequately.
"About a quarter of GPs in England are involved in some way with their CCG, whether as the chair or just as someone who sits on one of their committees, and thus has a lot of meetings to go to. That extra work related to commissioning services is cutting into the time they can spend with patients, just at the time that demand for GP services has been going up, so some GPs now have too much to do," said Chand."About a quarter of GPs in England are involved in some way with their CCG, whether as the chair or just as someone who sits on one of their committees, and thus has a lot of meetings to go to. That extra work related to commissioning services is cutting into the time they can spend with patients, just at the time that demand for GP services has been going up, so some GPs now have too much to do," said Chand.
"Some have already pulled out of active CCG work – attending meetings – because they can't cope with the dual workload of the managerial stuff around commissioning and looking after patients. While that's not happening on a large scale at the moment, it could become a wholesale pulling out if [the health secretary] Jeremy Hunt tries to force GPs to resume responsibility for providing out of hours care.""Some have already pulled out of active CCG work – attending meetings – because they can't cope with the dual workload of the managerial stuff around commissioning and looking after patients. While that's not happening on a large scale at the moment, it could become a wholesale pulling out if [the health secretary] Jeremy Hunt tries to force GPs to resume responsibility for providing out of hours care."
Meanwhile, a row between the government and the medical profession intensified as the leader of Britain's GPs accused the health secretary of "spouting rubbish" and rejected his demand that family doctors take back responsibility for out-of-hours care.Meanwhile, a row between the government and the medical profession intensified as the leader of Britain's GPs accused the health secretary of "spouting rubbish" and rejected his demand that family doctors take back responsibility for out-of-hours care.
Dr Laurence Buckman, chair of the British Medical Association's GPs committee – which represents the UK's 40,000 GPs – launched a sustained assault on Hunt over his "denigration" of GPs and his blaming of them for the growing crisis in A&E care.Dr Laurence Buckman, chair of the British Medical Association's GPs committee – which represents the UK's 40,000 GPs – launched a sustained assault on Hunt over his "denigration" of GPs and his blaming of them for the growing crisis in A&E care.
Buckman's speech, to Thursday's annual conference of the BMA's local medical committees (GP branches), highlighted the increasingly vocal unease about Hunt's approach felt by the BMA and the medical royal colleges which represent the UK's nurses and GPs.Buckman's speech, to Thursday's annual conference of the BMA's local medical committees (GP branches), highlighted the increasingly vocal unease about Hunt's approach felt by the BMA and the medical royal colleges which represent the UK's nurses and GPs.
Buckman rejected Hunt's call for GPs to resume responsibility for providing out-of-hours care overnight and at weekends in England, as they did until 2004 when 90% chose to cease doing so in a revised contract deal with the then Labour government.Buckman rejected Hunt's call for GPs to resume responsibility for providing out-of-hours care overnight and at weekends in England, as they did until 2004 when 90% chose to cease doing so in a revised contract deal with the then Labour government.
NHS Clinical Commissioners, the organisation that represents about 130 of the 211 CCGs, warned that "at practices across the country, workloads are at breaking points and GPs are ready to buckle under the strain" – and that Hunt's blaming of GPs for the alarming rise in patients attending hospital A&E departments was damaging GPs' morale.NHS Clinical Commissioners, the organisation that represents about 130 of the 211 CCGs, warned that "at practices across the country, workloads are at breaking points and GPs are ready to buckle under the strain" – and that Hunt's blaming of GPs for the alarming rise in patients attending hospital A&E departments was damaging GPs' morale.
Last month, Dr Chandra Kanneganti resigned as the clinical director for unscheduled care with Stoke-on-Trent CCG, just days after it assumed its powers on 1 April. He told the Pulse medical website at the time: "We need to spend more time at practices than we did before. Practice and patients are our main priority. With the recent changes in the [GPs'] contract, I'm not sure how long I can spend time on my commissioning duties. I don't want my patient care compromised."Last month, Dr Chandra Kanneganti resigned as the clinical director for unscheduled care with Stoke-on-Trent CCG, just days after it assumed its powers on 1 April. He told the Pulse medical website at the time: "We need to spend more time at practices than we did before. Practice and patients are our main priority. With the recent changes in the [GPs'] contract, I'm not sure how long I can spend time on my commissioning duties. I don't want my patient care compromised."
Hunt on Thursday struck a more emollient tone towards GPs in a speech setting out ways to improve the quality of primary care, such as hiring a new chief inspector of primary care and rating GP surgeries.Hunt on Thursday struck a more emollient tone towards GPs in a speech setting out ways to improve the quality of primary care, such as hiring a new chief inspector of primary care and rating GP surgeries.
On Tuesday, Hunt had claimed that GPs' failings were leading to overcrowded A&E units. Dr Laurence Buckman, chair of the BMA's GPs committee, yesterday made clear that GPs could not and would not take back responsibility for overnight and weekend care, a key ambition which Hunt reiterated.On Tuesday, Hunt had claimed that GPs' failings were leading to overcrowded A&E units. Dr Laurence Buckman, chair of the BMA's GPs committee, yesterday made clear that GPs could not and would not take back responsibility for overnight and weekend care, a key ambition which Hunt reiterated.
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