There are now 177 GP commissioning consortia covering two thirds of the country and 35 million people.
By 2013 the UK's National Health Service will comprise the National Health Commissioning Board, which will be in charge of the GP consortia. Alongside this will be the hospitals which will be Foundation Trusts running independently, much as they are now. SHA’s and PCTs will cease to exist.
So what does this mean for suppliers to the NHS?
We spoke to David Parnell, Chief Executive of the East Suffolk Federation, and asked this question. The main thing seems to be that nothing much has changed with regard to purchasing. Within the consortia GP practices (Practice Managers) will continue to buy as they wish, as will hospitals. However, if a consortium can see a major cost benefit in using a particular device or service they would recommend that all their member practices take it on; for instance, some consortia are looking to go with just one brand of blood glucose meter, to realign the whole BG testing area. It is problematic to get practices to agree on anything though – they tend to want to use the one they are familiar with.
A company could therefore go direct to the consortium if it is evidenced that their product will save practices lots of money. It would have to show cost savings over and above the use of the hospital path lab for example, in the case of diagnostic equipment. There might be an issue around accuracy and calibration and matching the hospital systems. The consortium would also have to look at whether if the patient was referred would they get this test anyway in a bundle? If so, it would not be worth the GPs doing the test.
Another example of consortia purchasing is 24hr BP machines. A local consortium bought them for all practices and purchased the machine that was consistent with the hospital – mainly in order that if the patient had to be admitted they wouldn’t have to re-test. It’s all down to a business case. A manufacturer would do best to trial their device or system in a few practices to demonstrate cost savings specific to the primary care sector.
Telehealth for CHF is being trialled in some areas and, if successful, will be rolled out. The Community Matron is alerted if any patient’s results are not within range and will respond. They deal with the very chronic patients and the telehealth systems will make better use of their services, since they are few in numbers.
We asked David what the priorities of the East Suffolk Federation were and he said, in this order: breaking even on their budget; engagement in practices and patients; reducing orthopaedic admissions (hip and knee replacements). With regard to breaking even on budget the main cost is emergency admissions, whose numbers are astronomical – children are more likely to be admitted at A&E, old people are more likely to have an ambulance called for them by nursing homes, more people walk into A&E for minor things. The consortia want to identify patiennts at risk and monitor them, to avoid admissions.
Thanks to David Parnell, Chief Executive of the East Suffolk Federation PBC for the above interview. The Federation comprises three GP consortia in East and coastal Suffolk and includes 26 practices.
