GP commissioning rejig sparks alarm

Plans to devolve commissioning from primary care trusts to GP
practices may badly affect mental health services, says a

Research by the Sainsbury Centre for Mental Health raises concerns
over the introduction of practice-based commissioning next

Under the new system, surgeries will be able to commission most
specialist services. But, although national tariffs will be set for
most services, mental health provision will be excluded from the
payment-by-results scheme because of the difficulty in dividing
services and applying distinct prices.

The charity said there were dangers that practices would choose the
cheapest options rather than the most appropriate services.

It was also concerned that there is no IT system available to help
doctors make choices about treatment.

Dr Alan Cohen, director of primary care at the Sainsbury Centre,
said: “Practice-based commissioning is the logical conclusion of
the government’s NHS reforms. But it will not work for patients
unless we can be sure that all services are of sufficient quality,
that choices are supported by good information and that cost
considerations do not distort decision making. None of these
conditions yet apply to mental health services in England.”

Guidance on the new system, unlike that issued for primary care
trusts, does not include a requirement on individual practices to
consult service users about services or give notification of plans
to change those they buy.

Cohen said: “To avoid destabilising mental health services we need
to see clear rules for practices to give plenty of advance warning
of changes to what they buy for their patient.”

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