GPs say they are being frozen out of Lord Darzi’s rollout plan for the NHS, as well as being given little to say in vital decision that will shape the future of general practice, according to an article published this week in Pulse. Three senior GPs, all members of Darzi’s primary care advisory board, reveal that three times as many consultants are involved in implementing Darzi’s plans as GPs.

GPs have been given merely 10% of places on the implementation teams so far appointed by SHAs to push forward Lord Darzi’s NHS Next Stage Review. There is concern that controversial SHA proposals will be implemented with very little GP input. This includes plans to move paediatric care to community specialists, for large scale polyclinics, and for a rollout of GP-led urgent care centres.

Royal College of General Practitioners chair Professor Steve Field said that in order to gain more influence with SHAs, the college has been forced to reorganise its lobbying process. Field said “The challenge is to get the GP voice across. Lord Darzi set things up as silos, but general practice cuts across everything – and in some SHAs there weren’t GPs on the groups. The default position is still to go to the specialist.”

Field’s fears were echoed by Dr. Michael Dixon, Chairman of the NHS Alliance, who advised Lord Darzi on practice-based commissioning, and by Sir. John Oldham, head of Quest4Quality, a consultancy. “We talk about localism, but if SHAs aren’t communicating with frontline clinicians, then it’s not local,” said Dixon.

Only 54 of the 547 clinicians appointed across NHS West Midlands, NHS South East Coast, NHS North East, NHS East of England and NHS North West, are GPs, while 145 are consultants. There is a growing risk that a series of controversial proposals will be pushed through without much GP input. NHS Yorkshire and Humber, singled out by the trio of GP advisers, last year put forward proposals for a new wave of large-scale polyclinics and for community specialists to take over routine paediatric care.

In other parts of the country SHAs are planning a rollout of urgent care centres. This proposal was attacked last week by shadow health secretary Andrew Lansley as ‘ill thought-out’ and ‘clinically unproven’.

Dr Dinah Roy, Sedgefield GP representative for County Durham PCT, said engagement of frontline GPs in the Darzi review had been half-hearted at best. “The message has not got across to people on the ground. People have been invited to workshops, but you have to take two days out of practice, and it’s not made clear what difference it would make if you went or whether you’d be listened to.”

“GPs provide a crucial frontline role in healthcare and have played a central role in the review process, which was locally led and clinically driven. Nationally they have played prominent roles in both the pathway and clinical groups and Lord Darzi met with the RCGP regularly throughout this process,” a spokesperson for the Department of Health said.

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Written by John Robinson