London GPs are off and running as 29 out of 31 London PCTs put forward local commissioning groups to be “Pathfinder consortia”. Big unresolved issues about who will inherit the accumulated debt in some essentially bankrupt PCTs haven’t put people off (not yet anyway).
Stampede to shadow consortia
It is great when Clare Gerada the new chair of the RCGP says, as she did her in her Pulse interview on 17 November, that “one of the most important areas is to get patients on side. If there’s one thing I’d recommend for consortia and practices to, it is to set up patient participation groups, because we absolutely have to get patients and the public on side. Patients have got to understand what’s going on.”
Governance matters first, last and always
But what we think really matters is how consortia sort out their governance and how the patient interest is recognised and represented. There is no sign in the latest November guidance from the General Practitioners Committee (GPC) of the BMA that patients or the public figure significantly in consortium governance thinking. And patients certainly don’t know what is going on.
GPC guidance ignores patients and public
We’ve highlighted the deficiencies in GPC guidance about patient and public involvement before. The latest November issues don’t encourage us.
Form and Structure of GP led Commissioning Consortia lumps everything into “stakeholder engagement”, viz “patients and the public, local authorities, secondary care and public health specialists”, as something to consider outsourcing to a support agency not as mainstream consortium business. So much for Mr Lansley’s dictum “Nothing about me with me”!
Shadow Consortia – developing and electing a transitional leadership is no better, being concerned mainly with slicing up power inside the shadow consortia before they go live. It is not about sharing the big decisions about how the consortium will work with patient groups or the public. “Public” doesn’t occur in the document and patient groups are seen as strictly external to the consortium. So much for the White Paper’s “duty” of patient and public involvement! If it isn’t a duty when the organisations are set up, there is little point in adding it on later
Dust Storm of Guidance
Is Mr Lansley reading this dust storm of GPC guidance? If so, what does he make of it?
The variance from the inclusive engagement sentiments in his White Paper is getting more pronounced as the Pathfinders speed further down the trail. Does anyone know where they are going – GPs, BMA – certainly not patients?
The Moore Adamson Craig Partnership supports user and public participation, trains lay representatives and develops responsive health, care and education organisations.