Clinical Commissioning Groups (CCGs) could take responsibility for the majority of GP funding from April next year under proposals put forward by NHS England.

The body’s Proposed next steps towards primary co-commissioning overview states that the functions most suitable for full delegation by CCGs could include General Medical Services (GMS) and Personal Medical Services (PMS) contracts, enhanced Services, including GP and Pharmacy, and Quality Outcome Frameworks (QOF).

Co-commissioning will improve provision of out-of-hospital services for the benefit of the local population and will lead to a more collaborative approach for designing local solutions for workforce premises, the overview says.

However, it also states that there is no appetite in CCGs to take on revalidation and performer’s lists and many CCGs also believe that individual and practice performance management aspects of contract management should not be open for delegation.

Meanwhile, it also states that, for legal reasons, the liability for primary care commissioning will remain with NHS England, so the body will require assurance that its statutory duties are being discharged effectively.

The proposals have been met by GP leaders with some dismay, as they described delegated commissioning as ‘the ultimate poisoned chalice for GPs’ at the annual Local Medical Committee (LMC) conference, with critics also warning that co-commissioning will lead to an increased number of conflicts of interest for CCG governing bodies and GPs in commissioning roles.

There are also concerns that the proposals could be a way of NHS England divesting itself of the more difficult responsibilities it currently bears without handing over any resources or personnel to deliver them. This could create an added burden for CCGs at a time when they are already overworked and under-resourced.