On Tuesday, 7 November, the Secretary of State for Health announced 52 Pathfinders for GP clinical commissioning and ESyDoc was very disappointed to find that they were not on the list.
The definition of ‘pathfinder’ is a ‘trail blazer’; ESyDoc had been seen by many in Surrey and across the country as a GP consortium which was leading the way through the new and unexplored territories of initially practise based commissioning and latterly GP clinical commissioning. As well as to ESyDoc members, this decision has come as a surprise to many others including GP commissioners, colleagues from the local PCTs and acute trusts and by a number of MPs.
As Joe McGilligan, the ESyDoc Chairman, had submitted a fully worked up application which it was felt had addressed all the criteria published at the time, he requested that Guy Boersma, South East Coast SHA Regional Director and Chairman of the Pathfinder Panel, attend the ESyDoc Board meeting on Thursday 9th December to discuss the reasons in more detail. Guy Boersma came to the meeting and during the discussion agreed that ESyDoc had passed the definition of a pathfinder but the SHA had taken the view that there was more to be learnt nationally from those consortia which were more challenged. At the request of members, he agreed to write a letter of explanation to be made available to everyone and put on the ESyDoc website. The body of this letter, written 9th December, is copied below:
Dear Dr McGilligan
Timing of GP Commissioning Consortia pathfinder status
Thanks for the opportunity to talk at your December meeting of the ESyDoc Board and explain that your pathfinder status has been delayed until the new year.
I was grateful for my reception and thought your Board were generous in their appreciation of my turning up to ‘face the music’ in a week when you feel let down by not featuring in the Secretary of State’s announcement yesterday.
I hope that the inclusion of an ESyDoc case study in our local press release helped in a small way yesterday to demonstrate our support for ESyDoc’s work. I am keen to work with you to dispel any misperceptions that ESyDoc has somehow done something wrong to not feature in yesterday’s announcement.
Please pass on this letter to colleagues to allay any concerns that ESyDoc is somehow no longer doing good work. You know how impressive your achievement is in reducing unplanned admissions from patients with COPD by a third, as well as the other ways in which you have improved services for patients.
Knowing of your and your consortium’s stamina and commitment, I will continue to plan on showcasing your work at the workshops and seminars being arranged with GP consortia for the New Year. I will continue to look for every opportunity to showcase the work of ESyDoc and other effective GP consortia, not all of whom are currently pathfinders. For example, in the near future we would like to work with you to test models of shared decision making between General Practice and patients as part of additional funding we have received this year for this purpose.
You asked me to write to confirm for your patients and your partners that pathfinder status will be available early in 2011 to all GP consortia who can demonstrate:
- evidence of strong GP leadership and support;
- evidence of Local Authority support; or
- an ability to deliver on local QIPP agenda
I am happy to confirm that you have demonstrated this to me already. I am trying to keep the bureaucracy to a minimum and don’t expect to require any more evidence beyond the [three] pages you have already provided. As soon as I have confirmation of the process and timetable to be applied consistently across the country I will let you know. This is likely to be just before or just after Christmas.
As well as satisfying the three criteria above, I thought it might be helpful to you if I shared information about the particular circumstances of the six pathfinders selected in the first wave in
- Dartford, Gravesham & Swanley Commissioning Group – how a long term PFI contractual commitment is addressed;
- The Coastal
- The North West Sussex Association of GP Commissioning Consortia– how a PCT changes when every GP Practice is in consortia committed to improving commissioning through General Practice
- Guildford & Waverley Commissioning Consortium – how good practice in addressing the upward trend in hospital treatment is spread across all GP Practices in a consortium
- Thames Medical (
- Surrey Heath Commissioning Group – how a consortium works with an acute provider whose catchment spans Local Authority, PCT and SHA boundaries.
I also took the view that it would be most useful if the first pathfinders in this region all had serious financial challenges to address, with fair-share funding of consortia coming in.
Please do share this letter with your colleagues as you see fit. I will also look for further opportunities to get the message across that there is great work going on in consortia, and not just the 52 pathfinders announced yesterday.
Yours sincerely
Guy Boersma
Regional Director of Commissioning & Development
South East Coast SHA
