The 2010 NHS White Paper: Equity and excellence: Liberating the NHS signalled the Government’s intention to make groups of local GP practices – supported by an independent national board – responsible for the bulk of NHS commissioning. Drawing on the most relevant research this paper sets out the Nuffield Trust’s initial response to the Government’s proposals.
The formal consultation document ‘Commissioning for Patients’ is organised around five themes:
- Responsibilities;
- Establishment of GP consortia;
- Freedoms, controls and accountabilities;
- Partnerships;
- Implementation and next steps.
Our preliminary analysis suggests that the reforms are more likely to succeed if the Government can address a number of challenges arising from each strand. These include the need to: have more clarity around how hard rationing choices are to be made, and who will be responsible; ensure that GPs have the right levels of support to manage demand for hospital care while reducing variations in clinical practice; put into place the correct systems for managing financial risk; preserve the gains made to develop integrated ways of working; and introduce extremely robust local system management during the transition phase.