With the need to make ever increasing efficiency savings, commissioners are looking to close some services or change the way in which certain services are delivered. However, commissioners cannot simply make a decision and implement it as they have a statutory duty to consult. Failure to consult at all or to carry out a proper and transparent consultation may well come back to haunt the commissioner.
Recently the Cooperation and Competition Panel (CCP) accepted for consideration, a complaint against NHS Peterborough from a local equitable access centre, Alma Road Primary Care Centre (the centre). The basis of the complaint, which has yet to be investigated, underlines the importance for GPs, as commissioners, to ensure proper consultation is undertaken and that conflicts of interest do not arise.
In summary, the centre alleges the PCT has breached the principles and rules of cooperation and competition by:
- failing to ensure the separation between commissioning and provider services, as the consultation that was carried out into primary care and urgent care was led by GPs which the centre claims had a conflict of interest;
- failing to engage fully and transparently with existing and potential providers as the PCT did not consider the full range of alternative service reconfigurations;
- failing to cooperate to improve services;
- restricting patient choice; and
- failing to consider fully, the impact of the proposals on the high proportion of patients who come from an ethnic minority background.
The CCP will now investigate the complaint. Whatever the outcome it is a timely reminder for commissioners when considering service reconfigurations or closures that they ensure (a) they comply with their statutory duty to inform and consult and (b) the manner of consultation is consistent with the principles and rules of cooperation and competition. The Health and Social Care Bill imposes similar consultation obligations on clinical commissioning groups to those that apply now. Putting robust processes in place now will ensure more effective commissioning in the longer term.