Clinical commissioning needs input from specialist doctors, says new NHS Alliance discussion paper


Policy on the role of specialist doctors in the NHS reforms is not fit for purpose, according to a discussion paper published today by the NHS Alliance.

Specialists in Commissioning: Looking beyond current policy discusses the views of GPs and specialists on current policy on specialists in Clinical Commissioning Groups. The paper calls for policy to be more inclusive and flexible to allow both groups of doctors to develop positive relationships to enable integrated care across the primary-secondary healthcare boundaries.

The paper proposes a transformation of the traditional relationship between GPs and specialists in the NHS, which has increasingly been limited by professional and policy constraints and requirements, rather than necessarily by an ethos of common purpose and benefit for patients and the public. It states:

Proposals for specialist involvement in governance of CCGs, clinical senates and networks offer an opportunity for GPs and Specialists to collaborate, but also carry a risk of professional and service barriers between primary and secondary care if policy is not inclusive or based upon the perceptions and expectations of both groups of doctors.

Dr Minoo Irani, NHS Alliance’s specialists in commissioning network lead and author of the paper, said:

Specialists have an important role to play in supporting clinical commissioning. Simply making proposals for specialist involvement in CCGs, senates and networks, but not providing clarification or policy guidance, can create misunderstanding between GPs and Specialists and risks creating barriers to collaboration on a range of issues which are crucial for the future of the NHS.

The paper makes a set of recommendations in the following areas: specialists’ membership of governing bodies of CCGs; clinical leadership input into clinical senates; support and development of clinical networks; and role in integrated care.

It concludes:

GPs and Specialists are probably at their best with professional and clinical collaboration if their focus remains upon the common purpose of enabling high quality, patient centred care, albeit within the constraints of financial resources likely to be present for healthcare services over the next few years.

If policy around inclusion of specialists in CCGs is not sensitively delivered or appears as unnecessary interference by GPs, it is very unlikely then to contribute in any positive manner to making the NHS reforms successful.

Specialists in commissioning: looking beyond current policy (PDF). NHS Alliance, 13 Jan 2012.

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Andre Tomlin

André Tomlin is an Information Scientist with 20 years experience working in evidence-based healthcare. He's worked in the NHS, for Oxford University and since 2002 as Managing Director of Minervation Ltd, a consultancy company who do clever digital stuff for charities, universities and the public sector. Most recently André has been the driving force behind the Mental Elf and the National Elf Service; an innovative digital platform that helps professionals keep up to date with simple, clear and engaging summaries of evidence-based research. André is a Trustee at the Centre for Mental Health and an Honorary Research Fellow at University College London Division of Psychiatry. He lives in Bristol, surrounded by dogs, elflings and lots of woodland!

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