Hospital Dr News

Rethink in offing on recruitment to CCGs

A rethink of the way clinical commissioning groups recruit hospital doctors may be on the cards after figures show that they are struggling to appoint consultants to their boards.

CCGs are legally required to appoint a secondary care doctor to their governing body but so far only 7% of CCGs have managed to do so according to a survey by the magazine Pulse.

The data, released under the Freedom of Information Act, also reveals that only 36 out of 100 CCGs have reserved a position for a secondary care doctor.

The authorisation process for the 212 CCGs, which will assume responsibility for commissioning health services from April 2013, begins in September.

Regulations laid before Parliament last month stipulate that consultants must come from outside CCG boundaries to avoid conflicts of interest.

A spokeswoman for the NHS Commissioning Board Special Health Authority (NHS CBA), said: “Recruitment is in its early stages but clearly, if problems with such recruitment remain a widespread issue, the NHS CBA would need to consider its response.”

She denied this signalled a U-turn and said that CCGs could still be authorised with the condition that they continued to seek to recruit a secondary care doctor.

David Nicholson, NHS CBA chief executive told Pulse: “I think what we need to do is we need to go through this round of recruitment and then take stock. I’m very open about thinking about what the alternatives might be if we simply can’t get the quality. I don’t think CCGs should appoint people just for the sake of it. I think we should get the best people we can. If that means we might have to look in the local communities in the future then I’m open to that discussion.”

Dr Tom Kane, deputy chair of the BMA’s consultants committee, said they had  argued for the inclusion of consultants on CCG boards from the outset. “We also believed that the requirement for the consultant to be from outside the area or no longer practising was likely to be unworkable and the failure of CCGs to recruit suitable consultants has clearly borne this out.

“A decision to relax this restriction would be welcomed as the knowledge of local health issues will far outweigh possible conflicts of interest.”

Eddie Saville, general secretary of the Hospital Consultants and Specialists Association, said they agreed with the principle of secondary care doctors being appointed from outside the local area and questioned whether CCGs were doing everything they could to appoint consultants.

But he also questioned whether consultants themselves were clamouring to apply for jobs on CCG boards. “I have to say that with all the stuff that has been going on in terms of pensions and the pay cartel attack on terms and conditions of service this hasn’t been necessarily one of the key issues that’s been on consultants’ minds of late.

“Maybe now things have died down and maybe when they see this potential U-turn consultants may well start asking; what’s happening, why haven’t there been consultant appointments and why haven’t there been adverts for these jobs?”

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2 Responses to “Rethink in offing on recruitment to CCGs”

  1. Malcolm Morrison says:

    As I understand it, the PRIINCIPLE of having LOCAL CCGs was to have LOCAL GPs who knew the needs of the LOCAL population. Thus, if they are to have a consultant to represent ‘secondary care’, the same principle should apply.

    I cannot see why any consultant would want to serve on a CCG outside their area! But they are certainly needed to give the LOCAL ‘hospital view’ when commissioning any service.

    If they (the NHSCBA) do decide to rescind their rule and allow a local consultant to serve, the problem, today, will be how such a person should be (s)elected. In days of yore, there used to be Consultant Staff Committees which could have performed this function; now they are (mostly) gone, local consultants will have to get together and find a system of (s)electing ‘one of their own’ whom they can trust to represent the best interests of the hopsital service.

  2. Merabi says:

    Given that CCGs are membership based oritgnsaaions, (with all GP Practices in their area being members) they will have a clear conflict of interest in the procurement of services for which their members could be the provider. Even if it is delegated by the CCG members to boards/groups or officers in the CCG this will remain the case.I agree that they (CCGS) should make the commissioning decision on which services they need to meet the needs of their popualtion, however if a GP Practice could be a provider they should not then procure for two reasons.1. Application of the Nolan Principles: They may award to a Practice within the CCG therefore commisisoning from their own members and a perception of a conflct of interest will arise. The time taken to manage this and to respond to any FOI request in relation to how the decsion was reached etc would be an unneccesary waste of resource. 2. It breaks the principle of NHS Commissioning Board replacing 151 ways of doing things. CCGs once they have made the decision that a community based service should be procured and where a GP Practice could be the provider, should pass the procurement porcess to the NHS CB Local Area Team (LAT) to manage on their behalf. Once the procurement process has bene completed and the provider or AQPs have been selected then the CCG can manage the performance of the delivery of the contract in liaison with the LAT.

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