The new treatment for Wiltshire’s health care: divide it into three parts
It now looks certain that under the coalition government’s plan to put GP’s in charge of most of the NHS budget, Wiltshire will be divided into three Clinical Commissioning Groups (CCGs) – groups of medical practices which up to a month ago were called ‘GP Consortia’. After the pause in the legislation ordered by the prime minister, major change will come more slowly to the NHS, but change is coming fast and furiously to the government’s plans.
These new developments were outlined to Marlborough News Online during an interview with Dr Helen Kingston (pictured left) in between her surgeries and ward rounds at Warminster Community Hospital. She wrote the application by Wiltshire’s first cut of five GP consortia to take the initial step towards official approval. Dr Kingston is now joint chairman of one of the new groups and is in continuing talks on the final shape of services across Wiltshire.
For Dr Kingston’s views on the developing process of ‘NHS modernisation’ and background information see the companion story on her interview with Marlborough News Online in our features section.
These CCGs will commission the healthcare and treatment for the patients in their area – arranging and paying for contracts with hospitals and many other services. Marlborough will be in the group that runs from Ramsbury in the east to Corsham in the west, to Pewsey in the south and north to the border with Swindon.
This group has not published a name yet. But under the government’s ‘post pause’ rules its name will have to include those valuable brand initials ‘NHS’.
It will cover about 167,000 of Wiltshire NHS’ 455,450 population. When we spoke to Dr Jonathan Glover of the Marlborough Medical Practice in April, he expressed doubts about the size, as it was then planned, of the GP consortium which included Marlborough. He had hoped it would cover just a hundred thousand patients. As Dr Glover put it: “So far we have been advised that the bigger the better.”
Dr Kingston revealed that the three groups are likely to co-operate in an ‘over-arching’, Wiltshire-wide organisation to manage and administer the three groups’ human resources and payrolls, and the collection and reporting of statistical information. This is still being negotiated among the leading GPs in the three CCGs.
Dr Kingston welcomed the government’s change in attitude towards the management of the NHS. She said that the White Paper had implied that NHS managers are “a waste of space”: “There’s more talk now about having managers and recognising the value of good management. We have some really good managers in Wiltshire – and we need their expertise.”
As the government’s new plans become clearer – formulated in 181 amendments to the Bill still waiting in Parliament and a flurry of guidance papers – more tiers and frameworks of oversight, proper governance and consultation are being designed. These account for some of the several hundred new NHS quangos that Ed Miliband referred to in prime minister’s questions in the House of Commons on Wednesday.
Dr Kingston spoke about an impending regime of new “frameworks and frameworks within the frameworks”. And she believes that if the governance and consultation processes become too complex and expensive, so requiring the CCG’s to employ higher calibre management, then even these three Wiltshire CCGs might be too small to cope.