Few patterns in GP commissioning pathfinders

The first wave of GP commissioning 'pathfinder' consortia, announced in December by the government, covers 12.9m people, around a quarter of England's population. However, the differences between the consortia suggest that the Department of Health is happy to allow experimentation over how they should be constructed. An obvious aspect is the range of sizes. The average pathfinder consortia will group together 35 GP practices serving 239,000 people – which, if typical, would suggest that 210 consortia would commission England's healthcare, not many more than the 152 primary care trusts currently doing the job. However, that assumption is brought into question by the very wide range of sizes included within that average. The smallest consortium is the Red House Group, an existing group of three surgeries in Radlett, St Albans and Shenley, which serves 18,900 people, one of seven pathfinders serving a population of fewer than 100,000 people. Meanwhile, the largest by population is Oxfordshire, serving 672,000 people through 83 GP practices ( see profile article ). Not coincidentally, Oxfordshire is one of the few consortia that is based on an existing primary care trust area. There are pathfinders in every strategic health authority region, and different regions are hosting different kinds of consortia. East of England has the smallest average population size per consortium of 146,000, with seven relatively small named groups including Red House. This suggests they could be largely based on existing organisations. South Central's average consortium will serve 335,000, and apart from Calleva in Basingstoke, each group is based on an area. This suggests they are either being formed afresh, or are based on primary care trust areas. Meanwhile, the south-west's four groups are all companies of some kind, including WyvernHealth.com in Somerset ( see profile article ). Other areas, such as the north-west, have a mix of consortia, from Fleetwood Community Commissioning Group with 25,000 people to Cumbria Senate with 517,000 people and 86 GP practices ( see profile article ). The region also includes Manchester, which plans to form three consortia covering 105,000 people across the city. The range of sizes and types of consortia allows for experimentation. It might cause problems later as the remaining GP practices have to choose a consortia to join, and could be forced to fill in the gaps – although it's possible they would be able to join existing consortia. And health secretary Andrew Lansley is clearly more interested at this stage in trying new models and seeing what works, rather than keeping the picture tidy. Profiles of consortia: Oxfordshire , Bexley Clinical Cabinet , WyvernHealth.com , Cumbria Senate For map and data, see Guardian Heathcare Network where this article first appeared.