"The NHS will last as long as there are folk left with the faith to fight for it"
Aneurin Bevan

Friday, 1 April 2011

Latest GP Consortia

The government have announced the latest GP consortia, 42 of them covering 8.7m (or so, see below) people. The government spin machine says that "9 out of every 10 people to benefit from more personalised care", well my GP was named as part of a GP consortium in the last wave, and I have noticed no change whatsoever in my care. I think there is a bit of creative writing in that title!

The government also says that the number of GPs creating consortia show their unbridled enthusiasm for Lansley's wonderful and NHS-saving plans (or words to that effect). In fact that is not the case at all, as I have explained earlier. The GPs are merely being pragmatic. From today all debts generated by PCTs will be passed onto GP consortia when they take over the reigns in two years time. GP consortia are expected to share commissioning with the PCTs (or PCT clusters) in the next two years and hence they will be able to influence how money is spent. The reason for the number of GP consortia is clear: the GPs do not want to inherit debts and so want to prevent the PCT clusters from generating them.

The Department of Health provide details of the consortia on their website, however, I have noticed a few errors.

1) The Milton Keynes consortium, Premier MK (Isn't that a hotel, Ed?) is listed in the East Midlands section when it should be in the South Central section.
2) The Fourth Wave announcement lists Lincolnshire South West, but this is not listed on the consortia list.
3) The Fourth Wave announcement says that there are 5 new pathfinders in East Midlands covering a population of 2,199,110. (440k per consortia is a bit high.) The list of consortia gives the populations of four of them, which total 1,071,015. This means that the fifth one (Lincolnshire South West) covers 1,128,095. This seems excessive, I doubt that there are even a million people in Lincolnshire.

So ignoring Lincolnshire South West, the statistics are as follows.

There are now 223 consortia made up of 5144 GP practices, covering 44.6m people.

The average number of patients per consortia is 200k, the median is 164k.

The distribution of consortia size (light blue) compared to PCT size (dark blue) is shown in this figure:

Bear in mind that this is for the 152 PCTs which have (or will be) clustered into 40 clusters. So while the PCTs are clustering to get economies of scale, the consortia are sticking to the "small is beautiful" principle.

If we regard the median size for a PCT (282k) as just about financially viable, note that there are 173 consortia with a size smaller than this (ie three quarters). If PCTs have had to cluster to get economies of scale (note: this process started well before the 2010 election) it is clear that GP consortia will also cluster, or merge, some time in the near future.

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