HR framework limits commissioning scope

Money tied up in NHS reorganisation may be leaving GP commissioning consortia with little leaway to employ outside agencies, according to the NHS Alliance.

Dr Shane Gordon, co- clinical lead for the NHS Alliance’s GP Commissioning Federation, told EHI Primary Care that money tied up in the health service’s human resources framework was limiting the opportunity for consortia to use external organisations for commissioning support.

He added: “One of the promises of the white paper is to be able to seek support for commissioning activity from the market and many consortia would like to test that market out.

"Yet that brings consortia into direct conflict with the HR framework for the NHS, which is naturally seeking to avoid any large scale redundancies. That’s a difficult issue.”

Dr Gordon said PCTs were faced with the challenge of deciding on the future of NHS staff while meeting the white paper’s promise to allow consortia to use external agencies for commissioning support.

He said he had no information about how many redundancies had been made by PCTs so far but said the “demands of the management cost reductions in the NHS are steep” and predicted they would be likely to take effect soon.

Dr Gordon leads the North East Essex Commissioning Group, which was one of 80 new pathfinder consortia announced by prime minister David Cameron yesterday.

He said he expected his own group to segment commissioning functions into those requiring close support, where it would be make sense to directly employ staff, and those functions that would be better done at scale, and for which an external organisation could be used.

He said his group would employ staff from the PCT and predicted that staff in PCTs nationwide would start to be assigned to consortia “in the next couple of months”.

“In our PCT we have staff across a series of disciplines such as commissioning, finance and information who have the skills and the organisational memory that we are keen to secure, ” he added.

Dr Gordon said his commissioning group would also like to start using outside agencies “early” to gain experience and test the market but said financial constraints might limit their ability to do so.

The announcement of the second group of GPs to lead on the government’s commissioning strategy was welcomed by the NHS Alliance which said it was delighted there was a “strong appetite” among front-line clinicians to take on commissioning.

Dr Michael Dixon, chair of the NHS Alliance, added: “Both groups of pathfinders now cover over 50% of the country, more than the GP fundholding scheme ever managed.

"This is an extraordinary achievement considering the white paper was published only a few months ago.” The government’s Health Bill on the NHS reorganisation is due to be published tomorrow.