A recent survey has found that despite only a quarter of GPs supporting Clinical Commissioning groups’ (CCG) management of contracts, a huge percentage support certain elements of co-commissioning.

Almost 80 per cent of those polled supported CCGs designing new enhanced services, as they believed it would create variation in services. Over 70 per cent were in favour of them creating local alternatives to the Quality Outcomes Framework (QOF), believing that this could help target funding at local needs. Meanwhile, more than 50 per cent backed CCGs being able to establish new practices and monitor contract performance.

In addition, around 40 per cent supported CCGs designing Private Medical Services (PMS) and Alternative Providers of Medical Services (APMS) contracts and controlling discretionary payments, but GPs were less keen on handing other functions to GP-led CCGs.

In fact, more than 60 per cent of those surveyed opposed giving them the power to remove contracts and almost half opposed CCGs taking contractual action, such as issuing breach notices, with many fearing conflict of interest from possibly ‘predatory’ GP rivals.

It is expected that around 90 per cent of CCGs will take on one of three levels of co-commissioning from April, with many taking fully delegated control. Meanwhile, others will opt for shared responsibility with NHS England or for greater involvement.

CCGs will not performance-manage individual GPs but, under the delegated model, they will oversee contractual performance budgets and complaints management, while under delegated and joint arrangement models, CCGs will be able to design local incentives that could replace the QOF or directed enhanced services. However, GPs should note that this will not affect practices’ rights under the GMS contract.