White Paper: GPs will need to buy in specialist support

GPs will need to buy in expertise to meet the needs of vulnerable groups, NHS leaders admitted after plans to give family doctors responsibility for health commissioning sparked concerns from social care charities.

Under the proposal, at the heart of this week’s health White Paper, consortia of GP practices would take control of £80bn from primary care trusts by 2013 to commission acute, community and mental health services.

The plan sparked warnings from charities representing mental health service users, people with learning disabilities and dementia patients, that GPs would be ill-equipped to meet vulnerable adults’ needs .

A survey published this week by mental health charity Rethink found just 31% of GPs felt equipped to take on the role of commissioning mental health.

Mark Goldring, the chief executive of Mencap, cited a survey published by his charity last month, which found more than half of doctors said they needed specific guidance on adapting care to meet the needs of learning disabled people.

“If GPs are not equipped and confident to give patients with a learning disability the healthcare they need, there is a risk that this new system will fail to meet their needs,” he said.

But Dr Mike Dixon, a GP who commissions services and is chair of primary care umbrella body the NHS Alliance, said: “We aren’t saying we have all the knowledge we need. What I – and others – will do is bring in that knowledge and experience that is elsewhere. The job is about GP leadership and not takeover.”

He admitted that, although he spoke regularly to social services, other GPs were not so involved, and there was the likelihood of more social workers and community psychiatric nurses being based in GP surgeries.

Dixon added: “For the first time in 25 years I have a social worker in my practice. I hope we will see people like community psychiatric nurses working in practices.”

Jo Webber, deputy policy director at the NHS Confederation, said: “There will [need] to be a large knowledge transfer in this. It may be that you transfer the person, but not necessarily. But it is important you transfer the knowledge of what works and what doesn’t. Some GPs already have this knowledge.”

Their views were backed by care services minister Paul Burstow, who said organisations with expertise in mental health could be hired by GP consortia to support them in commissioning psychiatric services.

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