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Record learning outcomes

The influence exerted by GPs on clinical commissioning groups and service funding streams came under scrutiny last month at Avicenna's autumn conference in Leicester. Speakers agreed that the playing field was far from level (reports Richard Thomas).

Chief executive Salim Jetha highlighted the resistance from GPs to pharmacists providing new services such as flu vaccinations and suggested that vested interests were undermining the commissioning process. €Can CCGs really be trusted to leave aside self-interest in favour of patients?€ he asked.

Dr James Kingsland, president of the National Association of Primary Care, questioned why some CCGs were apparently intent on trying to recycle baseline funding from local enhanced services [LES], historically delivered by GPs, back to general practice. €I believe this is challengeable,€ he said.

Local enhanced services such as alcohol misuse and outpatient care should be open to competition. Pharmacists should talk to CCGs about what services they could bid for. A range of service providers rather than the current model best serves the needs of local populations, Dr Kingsland suggested.

€Don't wait for commissioning,€ he told delegates. €If there are ways of managing care more efficiently with the same or better quality, these should be explored.€ Pharmacists should bid for services collectively and look at setting up federated models for delivery. He also called for more collaborative working between GPs and pharmacists. €It's about co-provision, not just co-location.€

Pharmacists should think imaginatively and extend their horizons. €Why doesn't pharmacy run general practice?€ he suggested.

Get familiar with new target group

PSNC's head of NHS services, Alastair Buxton, urged delegates to familiarise themselves with the new MUR target group €“ patients at risk of or diagnosed with cardiovascular disease €“ even though an implementation date for the new MUR service targets had not yet been set. An announcement is expected before Christmas.

Changes to the MUR service, including the requirement to carry out at least 70 per cent of MURs in any given year on patients in one or more of the national target groups (up from 50 per cent), formed part of the new funding settlement recently agreed between PSNC and NHS England.

The NMS would continue as a permanent service and was now embedded in the contract as NHS England recognised its importance. €There will be no more stop and start,€ Mr Buxton said.