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The Department of Health has launched new commissioning guidance for primary care trusts aimed at setting standards for high quality care wherever services are delivered.
Members of the public who took part in the consultation leading to the 2006 white paper Our Health, Our Care, Our Say made it clear that although they thought that receiving medical care closer to home was a good idea, this must not be at the expense of quality.
The health department has responded by publishing a new set of national guidelines aimed at providing practical support to commissioners when they bring specialised services closer to patients' homes. The guidance includes details of the accreditation process for GPs with a special interest.
The first part of the guidance reminds commissioners that a whole range of healthcare professionals can be involved in providing good quality care close to home, as long as they have the correct competencies and work within tight clinical governance frameworks. Such professionals include hospital consultants, non-consultant career grade doctors, GPs and pharmacists with a special interest, and specialist nurses.
The second part summarises the commissioning cycle—assessing need, reviewing current service provision, deciding priorities, and designing services.
The third part reminds commissioners of the definition of the GP with a special interest, which emphasises the core generalist role of the GP but also their ability to provide a service beyond the scope of the core role and their need to have demonstrated appropriate skills and competencies in delivering services without direct supervision. The document then outlines the steps required to accredit such a GP and gives detailed information on the accreditation panel and the process of accreditation.
At the same time, new guidance for the accreditation of GPs with a special interest in dermatology is being launched. This replaces the 2003 guidance and is the first of the specialty specific frameworks to be updated.
It is not clear yet whether accreditation of GPs with a special interest will be mandatory, but it does seem likely. In response to a recent parliamentary question, the health minister Rosie Winterton said, “The department is currently considering options to mandate primary care trust compliance with the guidelines.”
Implementing Care Closer to Home: Providing Convenient Quality Care for Patients, parts 1 to 3, can be found at www.pcc.nhs.uk/173.php.