Policy on the role of specialist doctors in the NHS reforms is not fit for purpose, according to a discussion paper published today by the NHS Alliance.

Specialists in Commissioning: Looking beyond current policy discusses the views of GPs and specialists on current policy on specialists in Clinical Commissioning Groups. The paper calls for policy to be more inclusive and flexible to allow both groups of doctors to develop positive relationships to enable integrated care across the primary-secondary healthcare boundaries.

The paper proposes a transformation of the traditional relationship between GPs and specialists in the NHS, which has increasingly been limited by professional and policy constraints and requirements, rather than necessarily by an ethos of common purpose and benefit for patients and the public. It states:

Proposals for specialist involvement in governance of CCGs, clinical senates and networks offer an opportunity for GPs and Specialists to collaborate, but also carry a risk of professional and service barriers between primary and secondary care if policy is not inclusive or based upon the perceptions and expectations of both groups of doctors.

Dr Minoo Irani, NHS Alliance’s specialists in commissioning network lead and author of the paper, said:

Specialists have an important role to play in supporting clinical commissioning. Simply making proposals for specialist involvement in CCGs, senates and networks, but not providing clarification or policy guidance, can create misunderstanding between GPs and Specialists and risks creating barriers to collaboration on a range of issues which are crucial for the future of the NHS.

The paper makes a set of recommendations in the following areas: specialists’ membership of governing bodies of CCGs; clinical leadership input into clinical senates; support and development of clinical networks; and role in integrated care.

It concludes:

GPs and Specialists are probably at their best with professional and clinical collaboration if their focus remains upon the common purpose of enabling high quality, patient centred care, albeit within the constraints of financial resources likely to be present for healthcare services over the next few years.

If policy around inclusion of specialists in CCGs is not sensitively delivered or appears as unnecessary interference by GPs, it is very unlikely then to contribute in any positive manner to making the NHS reforms successful.

Specialists in commissioning: looking beyond current policy (PDF). NHS Alliance, 13 Jan 2012.