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Primary care merger for Greater Manchester halted after CCG leaders report a ‘lack of trust’

Plans to create a single primary care organisation for Greater Manchester have been halted after an independent review found “fierce criticism” of previous leadership and reported “anger,” “confusion” and a “lack of trust” towards the move.

The Community Health Partner’s review highlighted a number of issues with Trafford CCG’s conduct in establishing the new primary care organisation (PCO), identifying a number of consistent themes.

The review, which included a survey and interviews with GPs and stakeholders, found that over a half of interviewees expressed anger towards the approach to the development of the PCO, and a significant number of GPs said they felt misled by the process.

There was “a distinct feeling of confusion towards how decisions were made,” particularly around care strategy, and there was also “sometimes fierce criticism” of the CCG’s previous leadership with lack of a trust being a “significant issue.”

Despite the lack of understanding, the review said there was a majority view that the PCO was needed in some form “to act as a strategic voice at the table with the bigger system players.”

The respondents said that they believe the new PCO could help in addressing social inequality, helping to reduce practice workload, and incentivising change and accelerating innovation.

The project was led by Dr Nigel Guest, Trafford CCG’s former chief clinical officer, but he left the CCG in April.

The process was paused in July this year and an independent review was commissioned by the Community Health Partners to explore a number of issues with the work in more detail.

Following its research, the report said that the future direction of the new PCO would need to incorporate a clear vision for primary care, competent leadership, and a transparent and democratic election process.

It recommended that a more trusting relationship with the CCG be established before going forward, as well as a way of releasing funds and resources into primary care.

Its conclusion was that general practice in Trafford does not understand the current strategy and delivery model, but that there was “an overarching desire for a change of leadership.”

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