Commissioning powers will be devolved to GPs through the creation of GP consortia, which will be set up by 2012. They are expected to be responsible for 80% of the budget.
The proposed commissioning structure is as follows.
Important questions remain to be answered, including who will head up the NHS Commissioning Board and how is the Board going to set the budgets of the GP consortia? Is the relevant information available? PCTs struggled to manage their budgets. Will the GP consortia do any better?
Other components of the white paper proposals are:
- To review and streamline quangos by summer 2010
- For the new NHS Outcomes framework to set the direction (as determined by the Secretary of State) for the NHS from April 2011
- To reduce ministerial involvement
- For NICE to develop 150 quality standards over the next 5 years across health and social care for NHS Commissioning Board
- For patients to have choice of named consultant-led team for elective care by April 2011
- To create HealthWatch England and local HealthWatch ôindependent consumer championö within the Care Quality Commission
- For all hospitals to gain foundation status by 2013
- Payment by results linked to quality and extended to mental health, child and end-of-life
- To develop Monitor, the current independent regulator of foundation trusts, into an economic regulator from April 2012, with responsibility for all providers of NHS care from April 2013
- New dental contract