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No need for GPs to be over-awed by the members of the Shelford Group

The 10 NHS Trusts that are members of the Shelford Group see themselves as members of an elite group. But the members of this elite can be dealt with by general practitioners (GPs) and clinical commissioning groups. Here are my tips on how GPs and CCGs can do this.

1. Form your own consortia. General practices can work in federations and networks to share resources and expertise. CCGs can come together in joint commissioning activities. Working in larger groupings - whether it is of general practices or CCGs - will give you more bargaining power and greater consolidation of expertise to challenge the members of the Shelford Group.

2. Become skilled in using the language of evidence-based medicine, healthcare evaluation and data-driven healthcare in your dealings with the managers of the Shelford Group NHS Trusts. You will soon discover that many NHS managers are poorly trained in these essential components of modern healthcare delivery and in using NHS data to evaluate the performance of health services.

3. The Shelford Group Trusts may be large but like many NHS Trusts they often operate on very narrow financial margins and even a small shift in GP referrals (and hence in their income) can destabilise their clinical services - and sometimes even an entire NHS Trust. Use your commissioning power to move referrals to NHS Trusts that are more flexible and more responsive to your needs. If your CCG won't do this, then a group of practices can - under NHS hospital funding arrangements, money follows the patient. Write to the Finance Director, Medical Director and Chief Executive of the Trust to let them know what you are planning. The more GPs that contact an NHS Trust on a single issue, the more effective you will be at influencing the Trust.

4. Take back power from NHS England and Commissioning Support Units (CSUs). Many NHS managers in the former NHS commissioning organisations obtained new positions with NHS England and CSUs. What are all these managers doing and what value for money do they provide? Hold them to account for any top-slicing of your budgets to fund their activities and make a case with the Department of Health that consortia of clinical commissioning groups can take over many of their functions (and thereby make their managers redundant).

5. Finally, NHS managers often hope - that as busy clinicians - you won't have time to keep on dealing with them on a single issue. So if you have a strong case, be tenacious and don't give up in your dealings with them.

The 10 members of the Shelford Group are:
Cambridge University Hospitals NHS Foundation Trust
Central Manchester University Hospitals NHS Foundation Trust
Guy’s and St Thomas’ NHS Foundation Trust
Imperial College Healthcare NHS Trust
King’s College London Hospital NHS Foundation Trust
Newcastle upon Tyne Hospitals NHS Foundation Trust (Leonard Fenwick): £850m
Oxford University Hospitals NHS Trust
Sheffield Teaching Hospitals NHS Foundation Trust
University College Hospital NHS Foundation Trust
University Hospitals Birmingham NHS Foundation Trust

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