Lansley outlines plans for GP commissioning

Lansley says that decisions made by GP commissioning consortia which establish themselves now in shadow form will not be "set in stone for the longer-term". "This will enable you, wherever possible, to begin now to establish the knowledge of, and approach to, services which will inform your later decision-making. This does not pre-empt decisions on the more decisive shift to GP-led commissioning that we are proposing," he says, in the letter sent on 24 September 2010. Lansley writes that primary care trusts (PCTs) already have freedoms within the legislative framework to devolve commissioning decisions to groups of GPs and other clinicians. He says that the government actively encourages this "interim approach" and wants GPs that have decided to "take on more responsibilities in shadow form" to approach their PCTs for the support needed to start work immediately. "We intend that that there will be flexibility within the proposed new legislative framework for you to determine the governance and organisational structure of consortia, and there is no expectation that consortia should resemble PCTs in their own structures. We intend that only essential requirements (such as financial accounting) are set out as statutory duties," Lansley adds. But he tells GPs not to feel under pressure to form new working arrangements at this stage and says that their main consideration should be the "appropriate organisational form which most suits your own particular local circumstances". The health secretary goes on to describe the reforms outlined in the government's recent white paper Equity and Excellence: Liberating the NHS as "ambitious", but says he is confident that the plans will ensure the best health outcomes for patients. Speaking about the commissioning powers that GPs will have in the next few years, Lansley adds: "Over time, you will be free to develop your own commissioning arrangements, structures, sizes and governance as you learn from your experience and the experience of others."