MPs from the House of Commons Public Accounts Committee raised concerns today over potential conflicts of interest in the procurement of GP out-of-hours services by Clinical Commissioning Groups (CCGs), since the latter include GPs in their decision-making mechanisms. The Committee believes that this can lead to GPs awarding lucrative contracts to companies they have a stake in, a fear that has been expressed since the introduction of CCGs through last year’s healthcare reforms, and calls for tougher safeguards to be put in place to prevent this. In order to allay further conflict of interest concerns as it seeks to bring in CCGs to co-commission primary care services, NHS England has already this week announced measures to address these concerns, such as strengthening the role and training of lay members in CCG boards, as well as offering increased oversight through the participation of local authorities and Healthwatch representatives.
MPs were also concerned over the “complex and fragmented” nature of urgent and emergency services in England, which include A&E units, NHS 111 services, GP out-of-hours services, walk-in centres and urgent care centres. NHS England has consistently argued over the past year for a more integrated urgent and emergency care system, most recently supporting this in last month’s Five Year Forward View, but uncertainty remains over the exact form this system would take and how it will be organised. The body also recognised that the current system is unsustainable and fragmented and could benefit from reforms to achieve both service improvements and efficiencies.
Eighteen months after the introduction of the Health and Social Care Act, the reformed health system is still bedding in and finding its feet, amidst wide consensus that a combination of increased demand, a rising elderly population with complex needs and financial pressures from a still fragile economic recovery make it unsustainable. A better integration of the emergency system seems like the first crucial step in delivering a system viable in the long run.
