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The dual role of practice based commissioner and GP provider: avoiding conflicts of interest and ensuring probity

January 2008

The dual role of commissioner and GP provider is one which has drawn some attention and concern from within both primary and secondary care, as well as more widely. Despite being questioned by some, this unique role has been created as a result of government policies on practice based commissioning (PBC) and the shift of services from secondary to primary care or ‘care closer to home’. In addition, primary care trusts (PCTs) – some of which are the first to question GPs’ dual role – have been both commissioner and provider for a number of years.

This guidance seeks to illustrate how adherence to national guidance from the Department of Health (DH), the General Medical Council’s (GMC) 'Good Medical Practice' (2006) and supplementary guidance allows GPs to perform in this role without compromising their position or care for patients. In doing so, this guidance addresses the potential for conflicts of interest and/or probity issues to arise from the dual role. It does not however seek to address the more practical issues that are adversely affecting GPs’ ability to be effective commissioners and advocates for their patients, such as the problem of financial deficit across many PCT areas, or PCT pressures to commission in a certain way.

The BMA has produced a statement on principles for effective and successful commissioning, which can be accessed online - go there now.

The GPC has produced extensive guidance on PBC, which can be can be accessed online - go there now (log-on to access the full range of guidance).

To read the guidance in full, please click on the pdf icon on the right hand side of the page.