At least 30 GPs have resigned their positions on CCG boards since the transfer of commissioning responsibility in April, amid fears that rising practice workload is preventing even enthusiasts from implementing the NHS reforms, a Pulse investigation reveals.
Figures obtained under the Freedom of Information Act from 74 CCGs across England show that one in three boards have seen a GP member resign since April, while the overall proportion of CCG board members who are GPs also appears to have declined, from an estimated 49% last year to just 43%.
In at least four regions - Hull, Lewisham, Luton and Wyre Forest - the chair of the CCG has left their role. Extrapolated across all 211 CCGs, the figures suggest up to 80 GP board members may have already stepped down.
Some CCG leaders who have resigned their posts have cited the increased workload caused by this year's GP contract imposition as a reason for stepping down, while the BMA warned it expects many more to drop commissioning because of an unmanageable practice workload.
Dr Richard Vautrey, deputy chair of the BMA's GP committee, said: 'This is not a surprise and is a reflection not only of the workload and pressures of being involved in CCG work, but also of practice workload increasing dramatically - in large part as a result of the Government's contract imposition - which means GPs are having to make the decision to spend more time in the practice to be able to cope with the workload there.
'It is also a sign that GPs are getting fed up of the controlling nature of some area teams and NHS England and the continuing dysfunction of the new fragmented healthcare system. I would certainly expect more to follow.'
Dr Helen Tattersfield, the former chair of Lewisham CCG, told Pulse last month that she had had to resign because of workload pressures.
She said at the time: 'Because of the changes in the primary care contracting, there has been a lot of uncertainty about payment and claiming it, so [as a practice] we have had to concentrate to make sure things would happen, compared with the past when you knew the money you were getting.
'There is extra QOF [work] and it all requires a lot more attention so it was difficult to balance those things.'
Dr Chandra Kanneganti, the former clinical director of unscheduled care on Stoke on Trent CCG, told Pulse in April he enjoyed commissioning but had to resign from the CCG board as his patients were his 'main priority'.
Dr Simon Gates, who announced this month he would be leaving from his role as chair of Wyre Forest CCG, said that he was stepping down because he had been in the role for three years, since the CCG was in shadow form.
He said: 'My belief is that in a membership organisation, you cannot truly claim to be working well if you have not got rotation of the top clinical lead roles. We've worked hard to bring people on.'
However, he added that workload pressures meant he will be busier after stepping down and returning to a full-time GP role.
He said: 'The thing I am most nervous about is that the GP job is so busy. Usually when you retire it is to spend more time with your family, but I might have to spend less time with my family.'
Pulse's investigation also revealed that the proportion of GPs sitting on boards appears to have fallen since last year. GPs represented 406 out of 949 board positions - just under 43%. A similar Pulse investigation last year covering 100 CCGs revealed that GPs held 49% of the positions on boards.
Pulse editor Steve Nowottny said: 'The fact that CCGs have seen such a high turnover of GP board members in only the first six months since the NHS reforms came into effect suggests even the most enthusiastic GPs are struggling to juggle a commissioning role with the day job of seeing patients.'
'If the NHS reforms are to have any chance of succeeding then it is crucial that commissioning is led by frontline GPs who have a real grasp of the needs of their patients. The fact that so many GP commissioners have stepped down - combined with the apparent decline in the overall number of GPs on CCG boards - is undoubtedly concerning, and should give ministers pause for thought as they plan further sweeping changes to the GP contract next year.'